Week 5- OSA

Question 1

How many austrlains have OSA?

Answer 1

5%, 775,000

Question 2

How many poeple who have OSA are undiganosed and untreated

Answer 2

85-90%

Question 3

risk factors for OSA

Answer 3

Obesity(biggest), increasing age, male gender, anatomic abnormalities of upper airway, family history, alcohol/sedative use

Question 4

How does OSA occur?

Answer 4

Question 5

Consequences of OSA

Answer 5

can have neurocognitive and CV effects

Question 6

neurocognotive effects of OSA

Answer 6

• Getting tired during the day
• decreased quality of life
• increased automobile crahses

Question 7

cardiovascular consequences of OSA

Answer 7

• Systemic hypertension
• arrhythmias
• increased incidence of congestive heart failure, stroke, and MI

In fact there is a dose-dependant relationship between OSA severity and CV events

Question 8

First line OSA treatment and any problems?

Answer 8

CPAP, there is low compliance with only 50% of patients using it beyond 3 months

Question 9

Alternatives to first-line treatment for OSA

Answer 9

behavioural therapies, medical therapies, surgical therapies

Question 10

When deiciding on OSA treatment what must be considered?

Answer 10

patient preference( if they like it financially, aesthetically and will they adhere to it(comfort)) and how likely the therapy is thought to work from a clinical viewpoint.

Question 11

OSA behavioural therapies

Answer 11

weight loss. avoiding supine sleep, avoiding alcohol and sedative use before bed

Question 12

how does alcohol cause OSA events?

Answer 12

alcohol depresses the muscles of the URT causing apnea

Question 13

challenge with recommending weight loss for OSA?

Answer 13

OSA improvement with weight loss in non linear and unpredictable

Question 14

What is more effective lateral sleeping devices or CPAP?

Answer 14

CPAP> in reducing AHI but similar score were found on ESS sleep scale

adherence is greater for these tools though

Question 15

Medical interventions for OSA

Answer 15

Oral appliances, expiratory resistance values, suction devices

Question 16

do oral applciances reoslve OSA in everyone

Answer 16

no, its very variable(29-71%)

Question 17

How do expiratory resistance values work?

Answer 17

when people inspire, valves open and then when people expire, the valve closes and there’s increased resistance. this causes a positive pressure which opens up the airways

Question 18

are expiratory values effective?

Answer 18

on average, ~50% reduction in AHI

Question 19

challenges of expiratory values?

Answer 19

dont work if youre a mouth breahter

tolerance in the real world is poor

cost can be high in the long term due to constant repurchasing

Question 20

are oral pressure devices effective?

Answer 20

~40% reduction in AHI

Question 21

Surigical inteventions for OSA

Answer 21

Question 22

STAR trial findings

Answer 22