apnea surgery-snoring &mouth breathing

Sleep apnea surgery

Sleep  apnea  has been de fined  as cessation  of airflow at the level of nostrils and mouth lasting at least ten seconds.A sleep apnea syndrom is diagnosed if ,during seven  hours  of noctural sleep ,at least thirty  apnoeic  eleeppisodes are observed in both rapid  eye moement sleep,some of which must appear in NREM sleep.It is  frequently more convenient to use  an apnea index of then umber  of apneas per sleep-hour:using this notion  five apnea /hour or more are needed to diagnose a sleep apnea syndrom

Pathological sleep apnea  is classified a central,obstructive or mixed.In central apnea there are no respiratory movements.In obstructive apnea there is no airflow despite persistent respiratory  effort,with paradoxical movements of chest  and abdomen in an attempt to ovecome the upper airway  obstruction.In mixed  apnea  there is initially  no airflow or respiratory effort,but after an interval respiratory effort is resumed and eventually re-establishes airflow

Normal sleep

Respiration while awake is mainly under voluntary control,but during sleep mechanisms assume greater impotence.At the  onset the sleep,respiration is often irregular with short  apneic episodes.AS sleep becomes deeper,breathing  respiration becomes more regular.During REM sleep ,howevere,there is  decreased muscle  tone with  diminished responsiveness to hypoxia,hypercapnia and airway obstruction:there is an associated drop  in oxygen saturation  and a rise  in PaCO2 with irregular  respiration and occasional  apneic episodes

Pathophysiology and aetiology

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