Obstructive Sleep Apnea (OSA) PDF

OBSTRUCTIVE SLEEP APNEA (OSA) Patho Cause Disease Course & Expected Findings Obstructive Sleep Apnea (OSA) Breathing stops during sleep 10 sec & 5x/hr Muscles relax during sleep →tongue and neck structures displaced→upper airway obstructed, but chest movement is not affected→Apnea leads to gas...

OBSTRUCTIVE SLEEP APNEA (OSA) Patho Cause Disease Course & Expected Findings Obstructive Sleep Apnea (OSA) Breathing stops during sleep 10 sec & 5x/hr Muscles relax during sleep →tongue and neck structures displaced→upper airway obstructed, but chest movement is not affected→Apnea leads to gas exchange (hypoxemia), blood Co2 levels (hypercapnia) pH→sleeper wakes up (sleep deprivation) & corrects obstruction →cycle repeats Upper airway obstruction by the soft palate or tongue o Snoring (people do not hear themselves snore) o Excessive daytime sleepiness o Inability to concentrate o Irritability o Bedwetting or excessive urination at night o Reduced sex drive, fatigue, depression o Pharyngeal edema o Chronic OSA→increased risk of HTN, stroke, cognitive deficits, wt gain, DM, pulm & CV disease NUR3225 Module 2: OSA Updated 8/30/2020 MR 1 Obstructive Sleep Apnea (OSA) Risk Factors Diagnostics • • • • Obesity • Large Uvula • Short Neck • Smoking • Enlarged Tonsils or Adenoids • Oropharyngeal Edema STOP-Bang Sleep Apnea Questionnaire→A yes score to higher than three items indicate a high risk for OSA. Pulmonary Function Tests (PFTs) Overnight sleep study (Polysomnography) →directly observed for symptoms. Depth of sleep, type of sleep (EEG), respiratory effort (ECG), O2 saturation (pulse ox), & muscle movement (EMG) monitored NUR3225 Module 2: OSA Updated 8/30/2020 MR 2 Obstructive Sleep Apnea (OSA) Meds Procedures Complications & Nursing Care Modafinil (Provigil) – Not first line therapy. Promotes daytime wakefulness. May help patients who have narcolepsy (uncontrolled daytime sleep). Does not treat OSA cause. o Surgical management: ENT Referral →Adenoidectomy, uvulectomy, or uvulopalatopharyngoplasty, severe cases might need trach 1. Nonsurgical management: • Change Sleep position • Weight loss • Decrease ETOH • Avoid Sedative Medications 2. Setting Types a. BiPAP- MORE pressure when breathing in, LESS pressure when breathing out. b. APAP -Automatically Adjusts c. CPAP -CONTINUOUS Pressure, constant airflow NUR3225 Module 2: OSA Updated 8/30/2020 MR 3 NUR3225 Module 2: OSA Updated 8/30/2020 MR 4