MEDI7212 Lecture Notes - Lecture 52: Nasal Congestion, Circadian Rhythm, Sexual Dysfunction
Document Summary
Stronger upper airway obstruction that was opposing that originally turned on: smaller lateral wall. Partial obstruction - soft tissue vibration (snoring) & smaller airway. ~ breathing stops (apnoeas), abdomen and chest still move in attempts for airflow. ~ breathing is shallow (hypopnoeas), silence then patient wakes up (eeg arousal), o2 desaturation. Indexes o apnoea-hypopnoea index (ahi) is total number of apnoeas + hypopnoeas per hour: respiratory disturbance index (rdi) is total number of apnoeas + hypopnoeas + reras per hour. Similar cost to cpap but only lasts 1-4 years. Indication: mild to (cid:373)oderate o a patie(cid:374)ts who prefer a(cid:374) oral applia(cid:374)ce or do(cid:374)"t respo(cid:374)d to cpap, require adequate dentition. Individual construction is required (not self-moulded: adverse events, common - excessive salivation (75%), dry mouth or tmj discomfort. Serious - malocclusion (15% in first 2 years), gag. Increased markers of inflammation, arterial stiffness and atherosclerosis: nonalcoholic fatty liver disease.
