SLEEP APNEA PHYSIOTHERAPY-DEMOCLASS.pptx

SLEEP APNEA
INTRODUCTION
TYPES
CENTRAL SLEEP APNEA
OBSTRUCTIVE SLEEP APNEA
MANAGEMENT
MEDICAL MANAGEMENT
PHYSIOTHERAPY MANAGEMENT

1. SLEEP APNEA SLEEP APNEA PRESENTER, DR. SUMAIYA BANU, MPT (CARDIO)

2. What is sleep apnea???

3. Sleep apnea is a disorder in which  breathing  is interrupted or paused during sleep.

4. What may be the cause??

5. When there is not enough space to accommodate sufficient airflow in a portion of the upper airway during sleep.

6. When muscle tone is decreased ,

7. When there is imbalance in transmitting the signals between the brain and respiratory muscles

8. In adults, it is most commonly associated with  obesity , male sex , and  advancing age

9. Types??

10. Clinical Presentation…

11. Contributing Factors!!!

12. Factors that contribute to airway obstruction are Obesity Large neck circumference Large tongue or tonsils Narrow airway due to bony structures of head and neck Taking sedative medication Drinking alcohol Smoking Nasal congestion

13. Medical disorders associated with OSA include Stroke Hypothyroidism Metabolic syndrome Acromegaly Neurological disorders ( eg  myasthenia gravis )

14. Associated Factors…

15. OSA induced biological changes Intermittent hypoxia, Intermittent hypercapnia , Intrathoracic pressure changes, Sympathetic activation and Sleep fragmentation

16. OSA can cause Metabolic dysregulation , Endothelial dysfunction, Systemic inflammation, Oxidative stress and Hypercoagulation .

17. OSA has been shown to increase the risk for Systemic hypertension,  Pulmonary vascular disease,  Ischemic heart disease, Cerebral vascular disease,  Congestive heart failure and  Arrhythmias

18. History Possible risk factors , Co-morbidities , Snoring, and What a normal night of sleep is like to him/her.

19. Indices AHI (apnea-hypopnea index), RDI (respiratory disturbance index)

20. Clinical Examination: N ose , T onsils , P alate , T ongue , N eck circumference, U pper airways .

21. Questionnaires Epworth Sleepiness Score (ESS) for daytime sleepiness; Berlin questionnaire for common OSA risk factors and symptoms

22. Oximetry Analyse oxygen saturation of haemoglobin to help identify individuals unlikely to have OSA.

23. Tests Nocturnal polysomnography , and Home sleep tests.

24. Differential Diagnosis!

25. Asthma Central sleep apnea Chronic Obstructive Pulmonary Disease Depression Gastroesophageal reflux Hypothyroidism Narcolepsy Periodic limb movement disorder

26. Medical Management Acetazolamide, Opioids.

27. Surgical Management Tissue removal, Tissue shrinkage, Jaw repositioning, Implants, Nerve stimulation, and Tracheostomy.

28. Physical Therapy Aerobic Exercise, Upper airway muscle training, Oropharangeal Muscle Training, Tongue Exercise, Breathing Exercise, and Inspiratory resistance training .

29. Therapies Continuous positive airway pressure (CPAP ), B ilevel positive airway pressure (BPAP ), Adaptive servo-ventilation (ASV)