...An estimated 70 million Americans suffer from sleep disturbances; these disturbances can have severe consequences. The most common sleep disorder, obstructive sleep apnea, can result in significant clinical risks, increased morbidity and mortality, and decreased quality of life (Peppard et al., 2013; Punjabi, 2008; Rosen, Zozula, Jahn, & Carson, 2001). Obstructive sleep apnea, OSA, is a disorder in which the airway narrows or closes during sleep resulting in hypoxia and disruption in sleep stage. In 2007 the estimated prevalence of obstructive sleep apnea (OSA) was 3-7% of adult males and 2-5% of adult females (Punjabi, 2008). Recent population-based studies have estimated rates as high as 50% for moderate to severe OSA (Punjabi, 2008;...
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...Obstructive sleep apnea is a very common form of apnea which affects an individual’s sleep pattern; this condition causes cessation of breath or shallow breathing while asleep. Obstructive sleep apnea (OSA) occurs when there are consecutive episodes of complete or partial blockage of the upper airway during sleep. This blockage in airway causes the diaphragm and chest muscles to work harder in order pull air into the lungs and can also reduce the flow of oxygen to vital organs and cause irregular heart rhythms. Patients diagnosed with this condition often experience an array of symptoms such as daytime sleepiness or fatigue, Sudden awakenings with a sensation of gasping or choking, Restlessness during sleep, arrhythmias and are at risk of developing ischemic heart disease and other vascular related problems (Hsu et al., 2007). Several treatment options have been identified for individuals with OSA including continuous positive airway pressure (CPAP), weight loss to reduce pressure on the diaphragm, dental appliances, and surgical procedures. This study assessed patients who have undergone the uvulopalatopharyngoplasty (UPPP) procedure to determine if their upper airways have improved after the procedure. To make this determination, researchers used quantitative video endoscopic computer-assisted measurement (CAM) to show improvement in the apnea-hypopnea index (AHI). The researchers who conducted this study indicated that its design is prospective. Patients who participated...
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...BiPAP Titration of Patients with Obstructive Sleep Apnea Approved: 5/25/14 Effective: 06/01/14 DEFINITION Patients with OSA (Obstructive Sleep Apnea) may require an alternative to standard CPAP. This may be attributed to not being able to accept continuous pressure or having trouble exhaling. BiPAP therapy resolves this by reducing the pressure on exhalation, which in turn will decrease airway pressures. PURPOSE To acquire data from BiPAP therapy during a PSG (Polysomnogram) in patients that have shown an intolerance to CPAP. POLICIES Sleep techs will start BiPAP therapy on patients who have shown a documented resistance to CPAP therapy. Techs will respond to the following circumstances unless otherwise directed by the physician: Patient complains of pressure, or difficulty of exhalation, with a documented increase in the number of arousals, increase in the number of central respiratory events, failure to fall asleep, or even failure to maintain a seal orally, with a full facemask or chin strap. PROCEDURE A. Starting BiPAP Titration 1. Initiate BiPAP therapy by setting pressure to last CPAP pressure that resolved an event. Set IPAP (Inspiratory Positive Airway Pressure)at least 4 cm greater than the beginning EPAP (Expiatory Positive Airway Pressure). These pressures should usually be at least 4 cm to 6cm apart to substantiate BiPAP necessity, but individual...
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...I am writing about three news related articles that deal with current event medical topics. My first topic will be covering MERS the Middle East Respiratory Syndrome which is a respiratory virus, I will go more in depth about. Next, is Atrial Fibrillation (AFIB) this is an irregular heartbeat. Lastly I will discuss sleep apnea which deals with your breathing while sleeping. To begin with, I am going to talk about MERS. The middle east respiratory syndrome corona virus (MERS) is a Beta corona virus. MERS is closes to resembling Severe Acute Respiratory Syndrome (SARS) but doesn't spread as easy. SARS affected around 8,000 people around the world in 2013. MERS was found in the Middle East in the year 2012. It had come back last year in May but it was identified in Asia. There were about 160 who caught this respiratory infection and the reported death toll was 25. If patients traveled to the areas where this was found the Center for Disease Control (CDC) is urging doctors to check for the virus. Without close contact it is hard to catch this virus says experts. Further more, the common symptoms found when patients have MERS are fever, cough, and shortness of breath (SOB). The doctors can treat symptoms, but the doctors do not have a vaccine because this virus does not currently have a cure. This is even more serious for those who already have problems with their immune system. If leaving in or visiting an area infected by MERS wash hands often, avoid the sick, help your children...
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...Introduction of New Procedures A doctor asked me to come up with a procedure for the assessment and treatment of “Sleep Apnea in Adults”. There is wide variety of factors that I would have to consider in an attempt to write up and apply a new protocol or procedure: 1. Would this be within my scope of nursing? There are many resources to find information on my standards of practice. These resources include a variety of nursing organizations (including statewide, national and international), education institutions (including community colleges and universities), and my state’s Board of Nursing. Basically, I would ask myself if I have had the education, skills, and experience to properly assess and treat adults with Sleep Apnea. 2. How simple or complex should this procedure be? Will it be a simple questionnaire with a list of simple explanations of the treatments that I could give to my patients and let them fill (it) out or will it be a tool to be used by other medical professionals? This will determine how much and how thorough my research will be. Will I do comparative studies on other researcher’s work and studies, on the detection (screening with questionnaires and/or tools and procedures for diagnosing), and treatments (weight-loss programs, CPAP, MAD, surgery, etc…). Should I do studies of patient outcomes (short-term and/or long-term)? There is an abundance of educational resources to use for research. 3. How will I format it? Will it be something that I will want...
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...What Is Sleep Apnea? Sleep apnea (AP-ne-ah) is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound. Sleep apnea usually is a chronic (ongoing) condition that disrupts your sleep. When your breathing pauses or becomes shallow, you’ll often move out of deep sleep and into light sleep. As a result, the quality of your sleep is poor, which makes you tired during the day. Sleep apnea is a leading cause of excessive daytime sleepiness. Overview Sleep apnea often goes undiagnosed. Doctors usually can't detect the condition during routine office visits. Also, no blood test can help diagnose the condition. Most people who have sleep apnea don't know they have it because it only occurs during sleep. A family member or bed partner might be the first to notice signs of sleep apnea. The most common type of sleep apnea is obstructive sleep apnea. In this condition, the airway collapses or becomes blocked during sleep. This causes shallow breathing or breathing pauses. When you try to breathe, any air that squeezes past the blockage can cause loud snoring. Obstructive sleep apnea is more common in people who are overweight, but it can affect anyone. For example, small children who have enlarged tonsil tissues in their throats may...
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...Provigil you need to know Provigil pill is used in the treatment of sleep disorders. This is the basic statement which you will get if you search it on the website, but there is more to provigil pill than just treating sleep disorders. Provigil pill is safe to consume, but like majority of the medicines has its side effects on the human. The side-effects of Provigil are not prolonging. There is a lot of misconceptions about the use of provigil, in this particular article we would see the in and out of the medicine Provigil pill. How to use, what precautions to take and whether Provigil is safe or not? Human life is incomplete without sleep. If you are awake for more than 48 hours straight then you are troubling your health and body for the future. Sleep helps in reviving the body for the next day work. Sleep replenishes your body with the required amount of oxygen so that your body gets enough oxygen. Also, sleep helps your muscle get relaxed so that you can feel less stressed. Sleep helps in keeping the body fresh, making your skin get the required time to replenish itself. Provigil pill is important as it treats any problem related to sleep. Provigil helps in getting rid of sleep disorders. Sleep disorders are problems occurring due to changed sleep pattern, odd work shifts and maybe some health problems. Provigil pill is used in the treatment of narcolepsy, obstructive sleep apnea and daytime sleep. Sleep pattern alters most of the time due to work shifts and thus resulting...
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...Obstructive Sleep Apnea For many people, a night’s sleep consisting of tossing, turning, and snoring is relatively normal, and most think nothing of it. But for some people, it is more severe than just restless sleep, it actually is a potentially life threatening disease called Obstructive Sleep Apnea. Someone who is suffering from OSA has blocked airways while sleeping, and they actually stop breathing during their sleep. Being aware of what Obstructive Sleep Apnea is, knowing the signs and symptoms to look for, learning who is more susceptible to this disease, acknowledging how it would be diagnosed, being aware of its precursors, and understanding the available treatments, are all things that should be assessed and should be taken seriously....
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...home (especially birds and cats) Pertinent nasal problems: deviated septum, chronic sinusitis Allergies: particularly airborne particles such as animal dander, dust mites, cockroach droppings Medications he is currently taking: opioids, modafinil (Provigil), amphetamines (prescribed and illegal), OTC drugs, and herbals 2. The two main types of sleep apnea are Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA). OSA is the more common type and is usually a result of obesity. Obstructive sleep apnea occurs when the muscles in the back of your throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), the tonsils, the side walls of the throat and the tongue. When the muscles relax, your airway narrows or closes as you breathe in, and you can't get an adequate breath in. This may lower the level of oxygen in your blood. Your brain senses this inability to breathe and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don't remember it. Central sleep apnea or CSA is a less common form of sleep apnea that occurs when your brain fails to transmit signals to your breathing muscles. This means you make no effort to breathe for a short period of time. You may awaken with shortness of breath or have a difficult time getting to...
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...Sleep Apnea, the Silent Killer Sleep is just as necessary as food and water is to humans. It is important for recharging the body’s internal functioning systems, as well as to recover from the everyday stress of the waking world. However, there are over 12 million Americans out there suffering from a silent disease that is preventing them from achieving quality sleep rest, and that is because they have an untreated sleep disorder called obstructive sleep apnea (OSA). This disorder is characterized by marked repetitive episodes of breathing cessation ten seconds or longer, that occurs during at night while a person sleeps. During this time, their oxygen saturation drops, resulting in hypoxemia. These disturbances during sleep over time may affect...
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...Winningham’s Critical Thinking Cases in Nursing: Case Study 20: “Obstructive Sleep Apnea” Directions: * Answer the following questions and statements. * Each question is assigned a point value. * Submit the completed worksheet to the Dropbox no later than Day 7 of Unit 3. * Your instructor will post the grade for this Assignment in the Gradebook no later than Day 7 of Unit 4. Scenario: S.R. is a 69-year-old man who presents to the clinic because his “wife complains that his snoring is difficult to live with.” 1. As the clinic nurse, what routine information would you want to obtain from S.R.? (2 points) I would want to obtain a smoking history (if any). I would want to know about their sleep: the hours of sleep obtained per night, if they are waking frequently through the night, their posture during sleep. Information I would want to obtain would also include if they wake up feeling tired, if they awake frequently during the night, if they fall asleep during the day, if they awake with a headache, and if they are irritable or angry in the morning. I would want to assess vital signs (to include oxygen saturation level), history of recent illness/respiratory infection, any changes in weight, trouble breathing through the nose, stressors, and difficulty concentrating. I would also ask the wife how loudly he snores and if she notices a pause in his breathing. CASE STUDY PROGRESS After interviewing S.R., you note the following: * S.R. is...
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...One of the most common types of sleep apneas is obstructive sleep apnea. It is identified by recurrent episodes of partial or complete upper airway blockage during sleep. The upper airway and the throat collapse during sleep and the patient loses breath for seconds then the throat reopens when the patient awakes. (1) In addition, the diaphragm and chest muscles increases their respiratory efforts against the airway obstruction, which results in snoring and loud gasps. (2) Two common signs characterize obstructive sleep apnea. First, snoring that is loud and regular to the patient. Second, daytime sleepiness, which is the inability of remaining fully awake during daytime that results in fatigue and falling asleep during the day. Other symptoms that are less frequent include fragmented sleep, sensation of chocking and sore throat after awakening, poor concentration, morning headaches, irritability and depression. (3) The diagnosis of OSA is made through a polysomnography (PSG), which is an in-laboratory test that monitors the oxygen level, brain waves activity, and breathing patterns of the patient during sleep. After the PSG, a differential diagnosis is made to eliminate other sleeping...
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...he most common form of sleep apnea is “Obstructive Sleep Apnea”, a condition where the airways are blocked, causing breathing to be briefly interrupted multiple times during the night. Up until relatively recently, the standard of care for sleep apnea has been the CPAP machine, where air pressure is applied through a nasal mask. In 2006 the American Academy of Sleep Medicine included oral appliances as a first line of therapy for mild to moderate Obstructive Sleep Apnea and studies have repeatedly validated their efficacy. In Oral Appliance Therapy, an oral appliance is placed in the mouth and worn much like a mouth guard. It acts to keep your airways open. Oral appliances are also used to control snoring. Who provides Oral Appliance Therapy?...
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... * How do you sleep at night? * Describe your normal daily routine and sleeping routine? (Time you go to sleep; how long you sleep average every night) * What is your diet consisting of? * Do you have any breathing difficulty throughout the daytime? CASE STUDY PROGRESS After interviewing S.R., you note the following: S.R. is under considerable stress. He owns his own business. The stress of overseeing his employees, meeting deadlines, and carrying out negotiations has led to poor sleep habits. He sleeps 3 to 4 hours per night. He keeps himself going by drinking 2 quarts of coffee and smoking three to four packs of cigarettes per day. He has gained 50 lbs. over the past year, leading to a current weight of 280lbs. He complains of difficulty staying awake, wakes up with irritable most of the time and reports difficulty concentrating and learning new things. He has been involved in three auto accidents in the past year. S.R.’s vital signs are BP of 164/90, pulse of 92 beats/min, 18 breaths/min with SaO2 90% on room air. His examination is normal, except for multiple bruises over the right ribcage. You inquire about the bruises, and S.R. reports that his wife jabs him with her elbow several times every night. In her own defense, the wife states, “Well, he stops breathing and I get worried, so I jab him to make him start breathing again. If I don’t jab him, I find myself listening for his next breath and I can’t go to sleep.” You suspect sleep apnea. 2. Identify...
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...Emily Hanlon ENG 103 8 December 2010 Sleep Disorders Sleep is an essential part of every ones lives. Without a normal amount of sleep each night can cause accidents, affect your relationships, physical, and mental health. It is averaged that about 70 million Americans suffer from sleep disorders and many do not know the extent of their disorder or how they came about. The most common sleep disorders are insomnia, sleep apnea, and restless leg syndrome. Normal sleep takes place in five stages. Stage one is light sleep where you drift in and out of sleep and can be awakened easily. In this stage, the eyes move slowly and muscle activity slows. During this stage, many people experience sudden muscle contractions followed by a sensation of falling. In stage two, eye movement stops and brain waves become slower with only an occasional burst of rapid brain waves. When a person enters stage three, extremely slow brain waves called delta waves are combined with smaller, faster waves. In stage four, the brain produces delta waves almost exclusively. Stages three and four are referred to as deep sleep and it is very difficult to wake someone from them. In deep sleep, there is no eye movement or muscle activity. This is when some children experience bedwetting, sleepwalking or night terrors. In the REM period, breathing becomes more rapid, irregular and shallow, eyes jerk rapidly and limb muscles are temporarily paralyzed. Brain waves during this stage increase to levels experienced...
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