呼吸机01

Pathophysiology
It is also clear that airflow obstruction in
patients with OSAS there is an increase in the pharyngeal critical pressure
Pathophቤተ መጻሕፍቲ ባይዱsiology

Pathophysiology
An important cause of upper airway
narrowing is the deposition of adipose tissue in the soft tissue sorrounding the pharynx. Dysfunction of the upper airway muscles is another factor that contribute to the development of OSA.
FIGURE 6. A 24-year-old woman with facial abnormalities that contribute to obstructive sleep apnea. (Left) The receding lower jaw provides inadequate support for the lower lip, resulting in lip curling and a deep mental-labial fold (curved arrow). (Right) Shortness of the lower one third of the face (arrows) contributes to inadequacy of the airway.
Definitions
Often presents other features, such as loud
snoring, morning headaches, and dry mouth on awakening. During obstructive apnea, respiratory efforts persist, but airflow is absent at the nose and mouth while on central apnea both airflow and respiratory efforts are absent.
OTHER DEFINITIONS OF OBSTRUCTIVE SLEEP APNEA

AHI > 10 (46) AHI > 15 (12) AHI > 5 + symptoms (49) AI > 2 (23) AI > 20 (25)
AHI = Apnea-plus-hypopnea index; AI= apnea index
Definitions
OSA is describe as repetitive episodes of
complete or partial upper airway obstruction during sleep. As a result affected persons have unrestful sleep and excessive daytime sleepiness.
Pathophysiology
Anatomic compromises of the upper airway
is worse during sleep and those events are more prominent during REM sleep because of the hypotonia and atonia that involve most skelethal muscles, including the respiratory accessories muscles.
Pathophysiology
Review Article Obstructive Sleep Apnea DXY: POLKA
Rafael E. Coplin, MD
Introduction
“Damn That Boy” Said the old men,
“He’s gone to sleep again”. “Very Extraordinary boy”, said Mr. Pickwick. Does he always sleep in this way?
Introduction
“Sleep” said the old gentleman, “he’s always
asleep”. “Goes on errands fast asleep and snores as he waits at table” In 1837 Charles Dickens, in one of his novels describes some of the features of the disease that I am going to present.

Figure 1. Anatomy of obstructive sleep apnoea. Coronal section of the head and neck showing the segment over which sleep related narrowing can occur (arrows).
Epidemiology
A history of heavy snoring is reported in
more than 70% of adult patients with OSA. Symptoms related to apnea are more frequent in family members of affected patients than in age, sex, and socioeconomically matched control families
Introduction
Although OSAS was identified more than 3
decades ago, the majority of physicians have had no formal training in recognizing or treating the condition
Epidemiology
Epidemiology
Preliminary studies suggest an association
between untreated OSAS and an increased risk for cardiovascular disease including HTN and CAD.
Cephalometry has demonstrated a variety of
craniofacial and upper airway soft tissue anatomy that may predispose patients to obstruction during sleep, and affect the severity of OSA.
Pathophysiology
Obstructive Apneas are periods of cessation
of breathing despite a continued effort to breath, and this is a result of narrowing of the respiratory passage which may occur at one or more sites in the upper airway: (oropharynx, velopharynx, or hypopharynx).
Epidemiology
The prevalence of OSA in the United States
is 2% to 4% in middle-aged adults which is similar in magnitude to the prevalence of major diseases such as Asthma and Diabetes.
Pathophysiology
Many patients with OSA have been shown
to have a small posterior airway space , an enlarged tongue and soft palate ,an inferiorly placed hyoid bone, or a combination of these.

Pathophysiology
FIGURE 5. Elongated soft palate (arrows). In this patient, an increased anteroposterior dimension caused the soft palate to rest on the base of the tongue in the relaxed position.
Introduction
Obstructive sleep apnea syndrome(OSAS)
is by far the single most common disorder seen at sleep centers and is responsible for more mortality and morbidity than any other sleep disorder.
FIGURE 1B. Abnormal airway during sleep. Multiple sites of obstruction often occur in patients with obstructive sleep apnea. An elongated and enlarged soft palate impinges on the posterior airway at the level of the nasopharynx and oral pharynx. In addition, a retruding jaw pushes an enlarged tongue posteriorly to impinge on the hypopharyngeal space.