Sleep Apnea and Heart Failure

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http://www.healthcare.philips.com/pwc_hc...984200.pdf

Definition of Obstructive Sleep Apnea (OSA):
• Obstructive Sleep Apnea (OSA) is a potentially life-altering and life-threatening
breathing disorder that occurs during sleep.
• The upper airway repeatedly collapses, causing cessation of breathing (apnea)
or inadequate breathing (hypopnea) and sleep fragmentation.
• Sleep fragmentation results in chronic daytime sleepiness.

Prevalence:
• 50-60% of patients with impaired cardiac function suffer from sleep related
breathing disorders.1
• Nearly 30% of patients with severe heart failure suffer from daytime sleepiness.1
• 4% of men and 2% of women aged 30-60 meet minimal diagnostic criteria for OSA
with excessive daytime sleepiness (an estimated 18 million people). An even greater
number of people have subclinical apnea/hypopnea during sleep.
• The majority of OSA sufferers remain undiagnosed and untreated.

Consequences if OSA is Left Untreated:
• Hypertension
• Cardiac Arrhythmias
• Myocardial Ischemia
• Myocardial Infarction
• Stroke
• Motor vehicle and work-related accidents
due to sleepiness
• Decreased quality of life
• OSA patients, prior to diagnosis and treatment,
consume 2 1/2 times more health care resources
than patients without OSA.

Identification of OSA:
Signs and Symptoms
• Snoring, interrupted by pauses in breathing (apnea)
• Excessive daytime sleepiness
• Gasping or choking during sleep
• Restless sleep
• Intellectual deterioration
• Poor judgment/concentration
• Memory loss
• Irritability
• Hypertension
Nocturnal angina
• Depression
• Obesity
• Large neck/girth
(>17” in men, >16” in women)
• Oropharyngeal crowding
• Morning headaches
• Sexual dysfunction
• Nocturia

Identification:
The key signs and symptoms that indicate a high probability of OSA are:
excessive daytime sleepiness
plus
disruptive snoring or pauses in breathing (apnea)
or gasping or choking during sleep.

Diagnosis
• If a patient’s signs and symptoms indicate sleep apnea, evaluation
by a physician specializing in sleep disorders is recommended.
• A sleep study provides information about how a patient breathes and sleeps. The data
that is collected will enable the physician to determine the type and severity of sleep
apnea and determine treatment options. Also, information about the physiologic
consequences of the abnormal breathing events is obtained

Intervention:
Primary
• Positive Airway Pressure (PAP) therapy is the treatment of choice for Obstructive
Sleep Apnea. This therapy includes Continuous Positive Airway Pressure (CPAP),
automatic CPAP, and bi-level positive airway pressure.
Secondary
• Less common treatments include surgery, body position modification,
and oral appliances, which may be effective in certain individuals.
Overall
• Any intervention should include lifestyle changes such as weight loss (if needed),
good sleep hygiene, and avoidance of alcohol, sedatives, and hypnotics.

Impact of PAP Therapy:
PAP treats Obstructive Sleep Apnea by providing a gentle flow of positive pressure
air via a mask. The positive pressure air splints the airway open during
sleep to prevent airway collapse. This results in:
• Elimination of snoring and abnormal breathing events
• Absence of daytime sleepiness or fatigue
• Improved quality of life
• Reduction or elimination of comorbidities, such as hypertension
• Decreased consumption of health care resources
Obstructive Sleep Apnea is a serious, potentially life-altering and life-threatening condition that is:
• Easily identified
• Effectively treated

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Impact of PAP Therapy:
PAP treats Obstructive Sleep Apnea by providing a gentle flow of positive pressure
air via a mask. The positive pressure air splints the airway open during
sleep to prevent airway collapse. This results in:
• Elimination of snoring and abnormal breathing events
• Absence of daytime sleepiness or fatigue
• Improved quality of life
• Reduction or elimination of comorbidities, such as hypertension
• Decreased consumption of health care resources
Obstructive Sleep Apnea is a serious, potentially life-altering and life-threatening condition that is:
• Easily identified
• Effectively treated

You left out CHEAPLY TREATED! The cost of a brand new top of the line Automatic PAP machine with all the bells and whistles is a drop in the bucket compared to the ambulance ride to the ER, treatment in the ER, surgery, rehabilitation, nursing home during rehab, home appliances such as continued use of oxygen, walkers, etc., continuing care, and or possibly ending up a veg draining your entire families resources....even a funeral!