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Apnea–hypopnea Index
The Apnea–Hypopnea Index or Apnoea–Hypopnoea Index (AHI) is an index used to indicate the severity of sleep apnea. It is represented by the number of apnea and hypopnea events per hour of sleep. Apnea is the complete absence of airflow through the nose and mouth. Hypopnea is a partial collapse of the airway, limiting breathing. Apneas (pauses in breathing) must last for at least 10 seconds and be associated with a decrease in blood oxygenation to be considered. Combining AHI and oxygen desaturation gives an overall sleep apnea severity score that evaluates both the number of sleep breathing disruptions and the degree of oxygen desaturation (low oxygen level in the blood) during said disruptions. The AHI is calculated by dividing the number of apnea events by the number of hours of sleep. The AHI values for adults are categorized as: *Normal: AHI<5 *Mild sleep apnea: 5≤AHI<15 *Moderate sleep apnea: 15≤AHI<30 *Severe sleep apnea: AHI≥30 For children, because of their d ...
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Sleep Apnea
Sleep apnea (sleep apnoea or sleep apnœa in British English) is a sleep-related breathing disorder in which repetitive Apnea, pauses in breathing, periods of shallow breathing, or collapse of the upper airway during sleep results in poor ventilation and sleep disruption. Each pause in breathing can last for a few seconds to a few minutes and often occurs many times a night. A choking or snorting sound may occur as breathing resumes. Common symptoms include daytime sleepiness, snoring, and non restorative sleep despite adequate sleep time. Because the disorder disrupts normal sleep, those affected may experience sleepiness or feel tired during the day. It is often a chronic condition. Sleep apnea may be categorized as obstructive sleep apnea (OSA), in which breathing is interrupted by a blockage of air flow, central sleep apnea (CSA), in which regular unconscious breath simply stops, or a combination of the two. OSA is the most common form. OSA has four key contributors; these ...
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Apnea
Apnea (also spelled apnoea in British English) is the temporary cessation of breathing. During apnea, there is no movement of the muscles of inhalation, and the volume of the lungs initially remains unchanged. Depending on how blocked the airways are ( patency), there may or may not be a flow of gas between the lungs and the environment. If there is sufficient flow, gas exchange within the lungs and cellular respiration would not be severely affected. Voluntarily doing this is called holding one's breath. Apnea may first be diagnosed in childhood, and it is recommended to consult an ENT specialist, allergist or sleep physician to discuss symptoms when noticed; malformation and/or malfunctioning of the upper airways may be observed by an orthodontist. Cause Apnea can be involuntary—for example, drug-induced (such as by opiate toxicity), mechanically / physiologically induced (for example, by strangulation or choking), or a consequence of neurological disease or tra ...
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Hypopnea
Hypopnea is overly shallow breathing or an abnormally low respiratory rate. Hypopnea is typically defined by a decreased amount of air movement into the lungs and can cause hypoxemia (low levels of oxygen in the blood.) It commonly is due to partial obstruction of the upper airway, but can also have neurological origins in central sleep apnea. (Or if a person has sleep apnea caused by both causes, it is variously referred to by a number of names, such as mixed sleep apnea or complex sleep apnea.) Hypopnea is traditionally considered to be less severe than apnea (the complete cessation of breathing), while other researchers have discovered hypopnea to have a "similar if not indistinguishable impact" on the negative outcomes of sleep breathing disorders. In sleep clinics, obstructive sleep apnea syndrome or obstructive sleep apnea–hypopnea syndrome (as well as central sleep apnea) is normally diagnosed based on the frequent presence of apneas and/or hypopneas rather than diff ...
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Oxygen Saturation (medicine)
Oxygen saturation is the fraction of oxygen-saturated haemoglobin relative to total haemoglobin (unsaturated + saturated) in the blood. The human body requires and regulates a very precise and specific balance of oxygen in the blood. Normal arterial blood oxygen saturation levels in humans are 96–100 percent. If the level is below 90 percent, it is considered low and called hypoxemia. Arterial blood oxygen levels below 80 percent may compromise organ function, such as the brain and heart, and should be promptly addressed. Continued low oxygen levels may lead to respiratory or cardiac arrest. Oxygen therapy may be used to assist in raising blood oxygen levels. Oxygenation occurs when oxygen molecules () enter the tissues of the body. For example, blood is oxygenated in the lungs, where oxygen molecules travel from the air and into the blood. Oxygenation is commonly used to refer to medical oxygen saturation. Definition In medicine, oxygen saturation, commonly referred to as ...
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Harvard Medical School
Harvard Medical School (HMS) is the medical school of Harvard University and is located in the Longwood Medical and Academic Area, Longwood Medical Area in Boston, Massachusetts. Founded in 1782, HMS is the third oldest medical school in the United States. It provides patient care, medical education, and research training through its 15 clinical affiliates and research institutes, including Massachusetts General Hospital (MGH), Boston Children's Hospital, Dana–Farber Cancer Institute, Brigham and Women's Hospital, Beth Israel Deaconess Medical Center, Mount Auburn Hospital, McLean Hospital, Cambridge Health Alliance, The Baker Center for Children and Families, Spaulding Rehabilitation Hospital, and others. Harvard Medical School also partners with newer entities such as Harvard Catalyst, Broad Institute , Broad Institute of MIT and Harvard, Harvard Stem Cell Institute, the Center for Primary Care, and Wyss Institute for Biologically Inspired Engineering. History Harvard ...
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American Academy Of Family Physicians
The American Academy of Family Physicians (AAFP) was founded in 1947 to promote and maintain high-quality standards for family medicine, an offshoot of the classical general practitioner. It is headquartered in Leawood, Kansas. AAFP is one of the largest medical organizations in the United States, with 128,300 members in 50 U.S. states and territories, in addition to international members. The AAFP was instrumental in establishing family medicine as medicine's 20th primary specialty. The AMA's Council on Medical Education and the independent American Board of Medical Specialties granted approval to a certifying board in family medicine on February 8, 1969. History The AAFP was founded in 1947 as the American Academy of General Practice. The organization's name was changed on October 3, 1971, to "more accurately reflect the changing nature of primary health care". Mission and objectives The mission of the AAFP is to improve the health of patients, families and communities by ...
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Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder and is characterized by recurrent episodes of complete or partial airway obstruction, obstruction of the respiratory tract#Upper respiratory tract, upper airway leading to reduced or absent breathing during sleep. These episodes are termed "apneas" with complete or near-complete cessation of breathing, or "hypopneas" when the reduction in breathing is partial. In either case, a fall in oxygen saturation (medicine), blood oxygen saturation, a disruption in sleep, or both, may result. A high frequency of apneas or hypopneas during sleep may interfere with the quality of sleep, whichin combination with disturbances in blood oxygenationis thought to contribute to negative consequences to health and quality of life. The terms obstructive sleep apnea syndrome (OSAS) or obstructive sleep apnea–hypopnea syndrome (OSAHS) may be used to refer to OSA when it is associated with symptoms during the daytime (e.g. ...
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Respiratory Disturbance Index
The respiratory disturbance index (RDI)—or respiratory distress Index—is a formula used in reporting polysomnography (sleep study) findings. Like the apnea-hypopnea index (AHI), it reports on respiratory distress events during sleep, but unlike the AHI, it also includes respiratory-effort related arousals (RERAs). RERAs are arousals from sleep that do not technically meet the definitions of apneas or hypopneas, but do in some way disrupt breathing during sleep and cause respiratory symptoms that may cause an arousal. A RERA is characterized by increasing respiratory effort such as dyspneas (and thus decreasing esophageal pressures) for 10 seconds or more leading to an arousal from sleep, but one that does not fulfill the criteria for a hypopnea or apnea. Diagnosis The gold standard method for measuring RERAs is esophageal manometry, as recommended by the American Academy of Sleep Medicine (AASM). However, esophageal manometry is uncomfortable for patients, may disrupt sle ...
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