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Lecture 1


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November 9, 2017 Disorders of EDS: Apnea, PLMRLS, Narcolepsy Lecture Objectives Learn about the diagnosis and treatment, and impact on waking function in apnea, and PLMRLS, and Narcolepsy Describe the signs and symptoms, and nature of sleep apnea (OSA and CSA). Outline the daytime consequences of apnea. Compare the current treatment options for apnea. Describe the clinical features, epidemiology, and diagnosis of PLM and RLS? Describe what is known today about the etiology and pathophysiology of RLS? Identify the recent advances with respect to understanding the causes of Narcolepsy? Sleep Apnea (Discovered 1965) Apnea (want of breath): a breathing disorder characterized by brief SIGNS AND SYMPTOMS: interruptions of breathing during sleep Associated completely with sleep, EDS (Excessive Daytime Sleepiness) Obesity not with asthma etc. Snoring almost all will snore, but snoring does Types of Sleep Apnea not mean you have sleep apnea Witnessed Apneas Central Sleep Apnea (CSA): brain fails to Bed partner reports they saw their send signals to breathing muscles to initiate partner stop breathing for several respirations seconds, take a gasp of air, wake up Less prevalent and go back to sleep. Neurons in brainstem not They stop breathing hundreds of times periodically over the night. functioning, dont signal the rest of the brain to carry out breathing. Morning Headache Dry Mouth These periods of not breathing can Narrowed Airway be quite long Highly prevalent Obstructive Sleep Apnea (OSA): air cannot flow in or out of persons nose or mouth, although efforts to breathe continue More prevalent, commonly associated with obesity (more fatty tissue leads to this sagging more into the airway and blocking it) Apnea events can be quite frequent (2060 times in the night). The number of times recorded tell you your severity of sleep apnea Difference in this is that they are signalling to breath but something blocking them breathing so they wake up to gasp air. More likely to have apnea events while sleeping on your back Positional therapy (sleeping on side instead of on back) Prevalence and Gender all age groups and both sexes, more common in men, more common as you age 8 mil
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