Forums » Open clinical » Expedition and mountain medicine » Obstructive Sleep Apnea - Do you see them?
|
Obstructive Sleep Apnea - Do you see them?
posted at 12/1/2010 9:08 AM GMT
|
Posts: 1593
First: 24/12/2008 Last: 14/5/2013 |
Am I wrong if I say general journals likes of BMJ, NEJM, Lancet, JAMA or Aannals of Internal Medicine have been overlooking OSAs? I'm sure sleep physicians are seeing them a lot but GPs or FPs will also be seeing them many more. There is increasing prevalence, right? Which part of the world/continent/country/race do you think it is increasing in ?
Any input/observation or experience you have? |
|
|
Re: Obstructive Sleep Apnea - Do you see them?
posted at 12/1/2010 3:39 PM GMT
on bmj.com
|
|
*Moderator*
Posts: 942
First: 10/9/2009 Last: 21/5/2013 |
Hi Mati, I once had an ACS patient with sleep apnoea in A&E... He had been up all night with chest pain which settled by the time he arrived, but naturally he was quite tired. While waiting for a bed on the ward, we had him in a high dependency bay with the necessary monitoring . You can imagine the panic when the patient had an episode of OSA
|
|
|
Re: Obstructive Sleep Apnea - Do you see them?
posted at 13/1/2010 6:54 PM GMT
on bmj.com
|
Posts: 1785
First: 7/3/2009 Last: 22/5/2013 |
Oh yes, I see them and at an early age. Unfortunately. there has been a shift in sleep disorders in adolescents from parasomnia to OSA. We had one with RDI of 60. I see in obese but also in normal BMI patients. There is another sub-population of those with very large tonsils and adenoids who also have obstructive sleep apnoea due their ENT problems. |
|
|
Re: Obstructive Sleep Apnea - Do you see them?
posted at 18/1/2010 2:12 PM GMT
on bmj.com
|
|
Posts: 1785
First: 7/3/2009 Last: 22/5/2013 |
No, there are other measures depending on severity. First, weight loss will help in many cases. When the obstruction is due to enlarged tonsils or adenoid the treatment will be surgical removal of the enlarged tissue. There are also other modalities such as radio frequency therapy and an operation involving the soft palate as well as laser treatment. And there is of course the CPAP when all other options do not fit. |
|
|
Re: Obstructive Sleep Apnea - Do you see them?
posted at 21/1/2010 2:14 PM GMT
on bmj.com
|
|
Posts: 1593
First: 24/12/2008 Last: 14/5/2013 |
That's great outline Yoram. Thanks! May be I'm talking to many adult, obese and OSA experts as I find them incredibly big fan of CPAP! CPAP outcomes are said to be great but the uncomofortability on using it must be overcome by the patient which will take time for sure. Thanks Sabreena on quick response of BMJ publication search on OSA! That's smart. |
|
|
Re: Obstructive Sleep Apnea - Do you see them?
posted at 22/1/2010 9:14 AM GMT
on bmj.com
|
Posts: 73
First: 29/7/2009 Last: 30/5/2011 |
As an ENT surgeon I see many. How do you tell a person with clear OSAS that they must exercise and lose weight when they are often too tired to just do their normal daily activites?
My approach is clinical examination - look for enlarged T's and A's or any other clear cause - (not often a problem in adults - OSAS is usually multifactorial) - do a sleep study to confirm the apnoea, and then move straight to CPAP.
If CPAP fails or is not tolerated, then I give surgical options - all of which are painful, expensive, often not covered by medical insurance, and not very successful in the long term!
But CPAP is a brilliant adjuct to help the patient make the lifestyle changes such as exercise and weight loss! |
|
|
Re: Obstructive Sleep Apnea - Do you see them?
posted at 14/12/2010 1:33 PM GMT
on bmj.com
|
|
Posts: 1593
First: 24/12/2008 Last: 14/5/2013 |
Continuous positive airway pressure as treatment for systemic hypertension in people with obstructive sleep apnoea: randomised controlled trialand the video is great as well! Thanks, mati
|
|
|
Re: Obstructive Sleep Apnea - Do you see them?
posted at 14/12/2010 8:19 PM GMT
on bmj.com
|
Posts: 2947
First: 10/3/2009 Last: 29/4/2013 |
I see patients with sleep disorders all day. I am a sleep physician. Seek and yee shall find. OSA is everywhere. As for your map, it leaves out most of the planet and is arbitarily orientated with the Northern Hemisphere on top. The fixation with the Americas on the map esp the North to me is offensive. It is part and parcel of the imperialist attitudes of those who reside there. CPAP was invented by Prof. Colin Sullivan, in Sydney, Oz. Resmed, an Australian firm make an excellent S9 Auto pump and Somnodent, also an Australian company make the best manibular advancement splint which I reserve for mild to moderate OSA in younger people who are not obese and can advance their mandible adequately. I always do a splint study to check its efficacy. |
|
|
Re: Obstructive Sleep Apnea - Do you see them?
posted at 14/12/2010 9:19 PM GMT
on bmj.com
|
Posts: 1178
First: 19/4/2010 Last: 21/5/2013 |
We have a dedicated Sleep clinic in Dundee. I don't run the service, and only fill in in case of emergency, but we have good experience with resmed, and Fisher and Paykel kit (Sorry Odysseus, they're Kiwi...). About 4% of the Scottish population are estimated to have OSAH. But if you add into that the OHS patients, who knows.... (And your map misses out Scotland too, ;-) )
|
Forums » Open clinical » Expedition and mountain medicine » Obstructive Sleep Apnea - Do you see them?
