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Sleep Disordered Breathing

Sleep-disordered breathing (SDB) is upper airway obstruction that occurs during sleep. It was originally discovered in the 1960s.

SDB embodies a group of physiopathologic conditions that are identified by an irregular respiratory breathing pattern during sleep that can coexist with other respiratory, cardiovascular, nervous, or endocrine diseases, or it can be isolated.

SDB is currently known to be extensively prevalent in the everyday population, and it is contributes to or responsible for numerous issues, ranging from traffic accidents to hypertension to fragmented sleep patterns.

Sleep-disordered breathing includes obstructive sleep apnea (OSA), which is when someone stops breathing for at least 10 seconds and take place in conjunction with increased inspiratory efforts during sleep. Central sleep apnea is expressed by similar apneas, but these instead occur in the absence of increased inspiratory efforts.

Obstructive Sleep Apnea Syndrome (OSAS) is a potentially disabling disorder characterized by disruptive snoring, repeated occurences of upper airway obstruction while sleep, night time hypoxemia (low oxygen) and excessive sleepiness during the day. It is characterized by a respiratory disturbance index or 5 or higher in association with extreme daytime sleepiness or the apnea-hypopnea index (the total episode number of hypopnea and apnea per hour of sleep).

Risk factors for sleep apnea include increased neck circumference, obesity, craniofacial abnormalities, acromegaly and hypothyroidism. Daytime effects include not only extreme sleepiness but also impaired judgment/cognitive achievement and disturbed moods which has an end result of reduced quality of life. Excessive sleepiness during the day is reportedly associated with a higher risk of motor vehicle accidents, poor work performance and increased work place injuries.

Essentially, everyone with Sleep Disordered Breathing snores, but not every person who snores has SDB. When someone snores with the absence of SDB, it is termed simple or primary snoring. However, evidence shows that snoring is one side of a clinical continuum with an opposite extreme of severe Obstructive Sleep Apnea. Some health problems are even related with primary or simple snoring.

Upper Airway Resistance Syndrome (UARS) is defined by snoring with greater resistance/obstruction in the upper airway, resulting in arousals/waking during sleep. This can disturb sleep function to the point of causing daytime sleepiness. No exact diagnostic studies exist for this entity. Patients with UARS can be effectively managed with Continuous Positive Airway Pressure (CPAP).

Treatment includes elimination of co-contributing factors and initiation of Continuous Positve Airway Pressure. CPAP is beneficial in improving sleep quality and decreasing daytime somnolence. Long-term treatment with CPAP reduces both the acute blood pressure elevation and mortality that occurs with Sleep Disordered Breathing. Eventually, a trend develops towards a decrease in baseline blood pressure in hypertensive patients with SDB.

Additionally surgical and medical interventions may be indicated.