Discussion

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Obstructive Sleep Apnea Hypopnea
This is a disorder that is diagnosed after repetitive episodes of airflow reduction, which is called hypopnea, or cessation, also known as apnea, due to upper airway collapse during sleep. This disorder could result in neurobehavioral and cardiovascular consequences, and that is why is important to diagnose this as soon as possible, and may be considered part of spectrum of sleep-related breathing disorders that includes the upper airway resistance syndrome and primary snoring. “Full-night polysomnography (PSG) involves an overnight stay in a sleep laboratory with multichannel monitoring for sleep physiology and architecture, brain activity, and respiration during sleep, and it is the standard method used to diagnose and grade Obstructive sleep apnea-hypopnea syndrome (OSAHS). In clinical practice, the diagnosis of OSAHS is made according to an apnea-hypopnea index (AHI) of ≥ 5 per hour, while the severity of OSAHS is categorized as mild, moderate, and severe with AHI thresholds of 5, 15, and 30 per hour, respectively, as determined by PSG” (Juang et al., 2021) This is a chronic disease that requires patient education, alleviation of upper airway obstruction, and ongoing follow up with adjustment of treatment strategies to ensure efficacy. In many patients, lifestyle modifications will decrease both the symptoms of OSAHS and the comorbid conditions. “Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common condition affecting 23.4% of women and 49.7% of men over 40 years old. The risk factors include age, male gender, cigarette smoking, obesity, and abnormal facial anatomy. The clinical symptoms are excessive daytime sleepiness, morning headache, decrease of cognitive performance, sexual dysfunction, decreased quality of life, and increased cardiovascular risk” (Minni et al., 2021) For the treatment of obstructive sleep apnea hypopnea syndrome, usually is use the Continuous Positive Airway Pressure (CPAP), which is a device that pneumatically splints the upper airway during inspiration and expiration. CPAP systems consist of a blower connected to a nasal interface by a flexible 180-cm hose, all weighing approximately 2.2 kg and transportable in a soft-sided case. “Increased daily CPAP use has been shown to be associated with greater improvements in OSAHS symptoms including daytime sleepiness, quality of life, and blood pressure. Maintaining long-term CPAP compliance remains a challenging task and hence, additional strategies need to be employed to improve this. Using CPAP requires the patient to make behavioral and lifestyle changes, such as wearing the mask and using noninvasive ventilation during sleep. Psychosocial problems such as depression, anxiety, or claustrophobia may affect CPAP adherence” (Li, Huang, Su, & Wang, 2020)
References
Juang, C.-F., Wen, C.-Y., Chang, K.-M., Chen, Y.-H., Wu, M.-F., & Huang, W.-C. (2021). Explainable fuzzy neural network with easy-to-obtain physiological features for screening obstructive sleep apnea-hypopnea syndrome. Sleep Medicine. https://doi-org.ezp.waldenulibrary.org/10.1016/j.sleep.2021.07.012
Antonio Minni, Cialente, F., Ralli, M., Colizza, A., Lai, Q., Placentino, A., Franco, M., Rossetti, V., & De Vincentiis, M. (2021). Uvulopalatopharyngoplasty and barbed reposition pharyngoplasty with and without hyoid suspension for obstructive sleep apnea hypopnea syndrome: A comparison of long-term functional results. Bosnian Journal of Basic Medical Sciences, 21(3), 364–369. https://doi-org.ezp.waldenulibrary.org/10.17305/bjbms.2020.4724
Li, Y., Huang, X., Su, J., & Wang, Y. (2020). Mindfulness may be a novel factor associated with CPAP adherence in OSAHS patients. Sleep & Breathing = Schlaf & Atmung, 24(1), 183–190. https://doi-org.ezp.waldenulibrary.org/10.1007/s11325-019-01858-8

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