Complications & Prognosis Of OSA

Common Problems
¢CVS Problems
¢Daytime Fatigue
¢Complications with Medicine & Surgery
¢Sleep-deprived partners
¢Nocturia
¢Impotence =P
¢GERD
¢ADHD

Daytime Fatigue
¢OSA make normal, restorative sleep impossible.
¢experience severe daytime drowsiness, fatigue and irritability.

Nocturia
¢Increased pressure=increased preload=increased CO
¢Heart works harder
¢Release of ‘atrial natriuretic peptide’(ANP) from atrial myocytes.
¢Function of ANP?

Impotence
¢Many hypothesis….still not confirmed
1.Many men have erections during REM sleep. I don’t okay… Since patients have less sleep..therefore less REM erections.
2.Levels of testosterone drops in patients with sleep OSA. Less testosterone=less manhood=ED

GERD
¢phrenoesophageal ligament (PEL) connects the diaphragm to the lower esophageal sphincter (LES).
¢During OSA ,increased respiratory effort by the diaphragm.
¢PEL will open the LES due to increased activity of diaphragm when threshold is reached.
¢Gastric fluid enter esophagus.

CVS Problems
¢Blood oxygen levels drop.Furthermore, levels of NO drops. Increase in blood pressure leading to hypertension.
¢Severe hypoxia/hypoxemia leads to sudden death…

Attention Deficit Hyperactivity Disorder(ADHD)
¢Definition=co-existence of attentional problems and hyperactivity, with each behavior occurring frequently together.empirical evidence that there is overlap in the central nervous system centers that regulate sleep and those that regulate attention/arousal.

Prognosis
¢Untreated:
1.life-threatening.
2.Fall asleep at inappriopriate times.
Impt: no cure for sleep apnea!!

Are children predisposed to snoring if their parents are ‘snorers’?
¢Chest(April 2006)
¢Researchers from Cincinnati Children's Hospital studied 681 children, 45% girls, 80% white.
¢parents filled in questionnaires-to determine if there was a link.
¢20% of the mothers and 46% of the fathers were habitual snorers .

Result
¢Incidence of snoring among infants who had at least one parent who was a habitual snorer was 3 X>than infants whose parents did not snore.