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    Obstructive Sleep Apnea, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Obstructive Sleep Apnea, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Obstructive Sleep Apnea, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Ebook174 pages2 hours

    Obstructive Sleep Apnea, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

    By Kenneth Kee

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    About this ebook

    Obstructive Sleep Apnea (OSA) is the medical disorder in which there is intermittent and repeated upper airway collapse during sleep.
    There is the absence of respiratory airflow (for 10 seconds or more) during sleep in spite of respiratory effort due to upper airway obstruction.
    It is typically featured by repetitive pauses in breathing during sleep in spite of the effort to breathe and is normally linked with a decrease in blood oxygen saturation.
    These pauses in breathing are called apneas (without breath) and normally last 20 to 40 seconds.
    Obstructive Sleep Apnea is a serious, potentially disorder that is life-threatening.
    Obstructive Sleep Apnea often goes undiagnosed and untreated.
    Left untreated, obstructive sleep apnea raises one’s risk for high blood pressure, motor vehicle crashes, heart attack, stroke, and other medical disorders.
    OSA is often accompanied with snoring.
    Causes of OSA are:
    a. Relatively low muscle tone,
    b. Narrow nasopharynx, and
    c. Large tongue, tonsils and adenoid.
    Sufferers who normally sleep alone have often no knowledge of the disorder without a regular bed-partner to observe and make them know their symptoms.
    As the muscle tone of the body ordinarily reduces during sleep, and the airway at the throat is made of walls of soft tissue, which can collapse, the breathing can be blocked during sleep.
    Diagnosis is by:
    1. Symptoms of snoring, nasal congestion and insufficient sleep are present
    2. Notice of airway obstruction during sleep
    3. Sleep study with monitoring devices such as
    a. Electroencephalogram (EEG)
    b. Electro-oculogram (EOG)
    4. Electrocardiogram (ECG)
    5. Blood oxygen levels
    Mild Sleep Apnea is normally treated by some behavioral changes.
    Losing weight, sleeping on the side is often advised.
    There are a variety of oral mouth devices (that keep the airway open)
    Moderate to severe Sleep Apnea is normally treated with a CPAP (continuous positive airway pressure).
    CPAP is a machine that blows air into the nose through a nose mask keeping the airway open and not blocked.
    Surgery treatment is:
    1. Radiofrequency reduction is for mild OSA
    2. Maxillo-mandibular Advancement is the most effective surgical intervention for treatment of OSA
    3. Laser Assisted Uvuloplasty (LAUP), is a surgical intervention to eliminate the uvula and surrounding tissue to open the airway

    TABLE OF CONTENT
    Introduction
    Chapter 1 Obstructive Sleep Apnea
    Chapter 2 Causes
    Chapter 3 Symptoms
    Chapter 4 Diagnosis
    Chapter 5 Treatment
    Chapter 6 Prognosis
    Chapter 7 OSA And Medical Disorders
    Chapter 8 Insomnia
    Epilogue

    I have a patient recently whom I sent to a sleep center for sleep disorder study.
    She was confirmed to have obstructive sleep apnea.
    Her heart specialist was particularly concerned because the ECG showed evidence of stoppage of her heart for a few seconds.
    He and the sleep specialist insisted that she wear the Continuous Positive Airway Pressure (CPAP) airway mask every night.
    Initially she fought against the feeling of suffocation but has found that her symptoms have become so much better that she bought her own CPAP airway for night use.
    There are some sleep apnea patients who had unable to tolerate the CPAP.

    LanguageEnglish
    PublisherKenneth Kee
    Release dateNov 3, 2016
    ISBN9781370311989
    Obstructive Sleep Apnea, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Author

    Kenneth Kee

    Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

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      Book preview

      Obstructive Sleep Apnea, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee

      Obstructive Sleep

      Apnea,

      A

      Simple

      Guide

      To

      The Condition,

      Diagnosis,

      Treatment

      And

      Related Conditions

      By

      Dr Kenneth Kee

      M.B.,B.S. (Singapore)

      Ph.D (Healthcare Administration)

      Copyright Kenneth Kee 2016 Smashwords Edition

      Published by Kenneth Kee at Smashwords.com

      Dedication

      This book is dedicated

      To my wife Dorothy

      And my children

      Carolyn, Grace

      And Kelvin

      This book describes the Obstructive Sleep Apnea, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

      (What You Need to Treat Obstructive Sleep Apnea)

      This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

      If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

      Thank you for respecting the hard work of this author.

      Introduction

      I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.

      My purpose in writing these simple guides was for the health education of my patients.

      Health Education was also my dissertation for my Ph.D (Healthcare Administration).

      I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

      This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Conditions into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

      From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.

      Some people have complained that the simple guides are too simple.

      For their information they are made simple in order to educate the patients.

      The later books go into more details of medical conditions.

      The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

      Since 2013, I have tried to improve my spelling and writing.

      As I tried to bring you the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

      Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

      I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

      I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

      I apologize if these repetitions are irritating to some readers.

      Chapter 1

      Obstructive Sleep Apnea

      I have a patient recently whom I sent to a sleep center for sleep disorder study.

      She was confirmed to have obstructive sleep apnea.

      Her heart specialist was particularly concerned because the ECG showed evidence of stoppage of her heart for a few seconds.

      He and the sleep specialist insisted that she wear the Continuous Positive Airway Pressure (CPAP) airway mask every night.

      Initially she fought against the feeling of suffocation but has found that her symptoms have become so much better that she bought her own CPAP airway for night use.

      There are some sleep apnea patients who had unable to tolerate the CPAP.

      What is Obstructive Sleep Apnea (OSA)?

      Obstructive Sleep Apnea (OSA) is the medical disorder in which there is intermittent and repeated upper airway collapse during sleep.

      There is the absence of respiratory airflow (for 10 seconds or more) during sleep in spite of respiratory effort due to upper airway obstruction.

      It is typically featured by repetitive pauses in breathing during sleep in spite of the effort to breathe and is normally linked with a decrease in blood oxygen saturation.

      These pauses in breathing are called apneas (without breath) and normally last 20 to 40 seconds.

      Obstructive Sleep Apnea is a serious, potentially disorder that is life-threatening.

      Obstructive Sleep Apnea often goes undiagnosed and untreated.

      Left untreated, obstructive sleep apnea raises one’s risk for high blood pressure, motor vehicle crashes, heart attack, stroke, and other medical disorders.

      Sleep apnea can be successfully treated and should not interfere with work duties as long as the patient follows their treatment.

      The patient with OSA has seldom knowledge of having difficulty breathing even after wakening.

      It is known as a disorder by others observing the patient during episodes or is suspected because of its effects on the body.

      OSA is often accompanied with snoring.

      Even though a very minor degree of OSA is regarded to be within the boundaries of normal sleep, and many patients have events of OSA at some time in life, a small percentage of patient are affected by chronic severe OSA.

      Many patients have events of OSA for only a short duration of time.

      This can be the effect of an upper respiratory infection that produces nasal congestion, along with swelling of the throat, or tonsillitis that temporarily causes very enlarged tonsils.

      The Epstein-Barr virus is recognized to be able to dramatically increase the amount of lymphoid tissue during acute infection, and OSA is fairly frequent in acute cases of severe infectious mononucleosis.

      Transient episodes of OSA syndrome may also happen in patients who are under the influence of a drug such as alcohol that may reduce their body tone excessively and affect normal arousal from sleep mechanisms.

      Patients with OSA who do not have sufficient sleep may have problem keeping awake during the day giving problems in their work during the day and keeping their family awake at night.

      What are the causes of OSA?

      Risk factors

      1. Being age 40 or older - Old age goes often together with muscular and neurological loss of muscle tone of the upper airway.

      2. Reduced muscle tone is also transiently induced by chemical depressants; alcoholic drinks and sedative medicines are the most frequent.

      3. Permanent premature muscular tonal loss in the upper airway may be induced by traumatic brain damage, neuromuscular diseases, or poor compliance to chemical and or speech-therapy treatments.

      4. Having a small upper airway - Patients with reduced muscle tone, higher amount of soft tissue around the airway, and structural features that produce a narrowed airway are at high risk for OSA.

      5. A large neck size (17 inches or greater for men, 16 inches or greater for women) - Men in whom the anatomy is featured by greater mass in the torso and neck are at higher risk of forming sleep apnea, particularly through middle age and later.

      6. Women normally are less often and to a smaller degree than do men as a result partially to physiology but possibly also to different levels of progesterone.

      Incidence in post-menopausal women reaches that of men in the same age region.

      7. Women are at greater risk for forming OSA during pregnancy.

      8. OSA also seems to have a genetic component - a family history of sleep apnea

      Those with a family history of it are more likely to form it themselves.

      9. Lifestyle risks such as smoking may also raise the chances of forming OSA as the chemical irritants in smoke are likely to inflame the soft tissue of the upper airway and promote fluid retention, both of which can lead to narrowing of the upper airway.

      A patient may also have or aggravate OSA by consuming alcohol, sedatives, or any other medicine that raises sleepiness as most of these medicines are also muscle relaxants

      10. In many craniofacial syndromes the unusual features affect the nose, mouth and jaw, or resting muscle tone, and put the patient at risk for OSA

      Down syndrome is one example.

      In Down syndrome, several features join together to make the presence of obstructive sleep apnea more likely.

      These specific features in Down syndrome that predispose to obstructive sleep apnea are:

      a. Relatively low muscle tone,

      b. Narrow nasopharynx, and

      c. Large tongue.

      Causes:

      Obstruction causes:

      1. Insufficient muscle tone of the palate, tongue and pharynx results in airway collapse during inspiration during the deep stage sleep.

      2. Large bulk of tissue in the upper respiratory airway (adenoids and tonsillar

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