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Authors

  1. Schaller, Judy RN, MSN

Article Content

MYTH: Patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) are obese.

 

FACT: Although obesity (defined as a body mass index greater than 30 kg/m2) is a risk factor for OSAHS, not all patients with the disorder are obese. Other risk factors include a neck circumference greater than 17 inches (43 cm) in men and 15 inches (38 cm) in women, hypertension, and facial dysmorphia that could cause upper-airway obstruction.

 

MYTH: OSAHS is primarily associated with pulmonary complications.

 

FACT: Most complications of OSAHS are cardiovascular because of the stress the disorder puts on that system. Having OSAHS doubles a person's risk of stroke or death.1 Systolic BP can rise as high as 300 mm Hg at the end of an apneic episode, which can damage organs and cause small strokes.2 Nocturnal platelet activation and aggregation are increased. OSAHS also has been associated with heart failure, ischemic heart disease, and dysrhythmias.

 

MYTH: The treatment of choice for all patients with OSAHS is continuous positive airway pressure (CPAP) ventilation.

 

FACT: Lifestyle changes such as losing weight or refraining from alcohol can improve symptoms in patients with mild to moderate OSAHS. For patients whose OSAHS doesn't respond to lifestyle changes, CPAP is the treatment of choice. If patients can't tolerate CPAP, laser treatment or surgery may be an option to remove excess tissue or mobilize facial structures to open the airway.

 

MYTH: Patients with mild OSAHS rarely suffer long-term complications.

 

FACT: Mild OSAHS puts stress on the body equivalent to 5 years of aging. Reduced performance during neuropsychological testing is demonstrated in even mild OSAHS. Patients feel constantly fatigued because they don't get enough deep sleep and may suffer decreased quality of life and increased risk of accidents.

 

references

 

1. Seppa N. Sleep apnea could signal greater danger. Science News. 168(22):349, November 26, 2005. [Context Link]

 

2. Phillips B, Somers V. Hypertension and obstructive sleep apnea. Current Hypertension Reports. 5(5):380-385, October 2003. [Context Link]