eMedicine Specialties > Pulmonology > Sleep-Related Disorders

Obstructive Sleep Apnea-Hypopnea Syndrome: Multimedia

Author: James A Rowley, MD, Associate Professor, Fellowship Program Director, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine
Contributor Information and Disclosures

Updated: Apr 2, 2009

Multimedia

Potential relationship between obstructive sleep ...
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Media file 1: Potential relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and the metabolic syndrome. OSAHS has been associated with 3 of the 5 major clinical abnormalities associated with the metabolic syndrome, which is hypertension, insulin resistance, and proinflammatory/oxidative stress. OSAHS may be contributing to and/or modulating the severity of these metabolic abnormalities.
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Potential relationship between obstructive sleep ...

Potential relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and the metabolic syndrome. OSAHS has been associated with 3 of the 5 major clinical abnormalities associated with the metabolic syndrome, which is hypertension, insulin resistance, and proinflammatory/oxidative stress. OSAHS may be contributing to and/or modulating the severity of these metabolic abnormalities.

The Mallampati score has been used for many years...
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Media file 2: The Mallampati score has been used for many years to identify patients at risk for difficult tracheal intubation.
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The Mallampati score has been used for many years...

The Mallampati score has been used for many years to identify patients at risk for difficult tracheal intubation.

Tonsil grades.
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Media file 3: Tonsil grades.
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Tonsil grades.

Tonsil grades.

Obstructive sleep apnea. Note the absence of flow...
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Media file 4: Obstructive sleep apnea. Note the absence of flow (red arrow) despite paradoxical respiratory effort (green arrow).
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Obstructive sleep apnea. Note the absence of flow...

Obstructive sleep apnea. Note the absence of flow (red arrow) despite paradoxical respiratory effort (green arrow).

Central sleep apnea (thick areas). Note the absen...
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Media file 5: Central sleep apnea (thick areas). Note the absence of both flow and respiratory effort (green double arrows).
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Central sleep apnea (thick areas). Note the absen...

Central sleep apnea (thick areas). Note the absence of both flow and respiratory effort (green double arrows).

Comparison of a central apnea (box) and obstructi...
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Media file 6: Comparison of a central apnea (box) and obstructive apnea (circle).
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Comparison of a central apnea (box) and obstructi...

Comparison of a central apnea (box) and obstructive apnea (circle).

Mixed sleep apnea. Note that the apnea (orange ar...
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Media file 7: Mixed sleep apnea. Note that the apnea (orange arrow) begins as a central apnea (effort absent; red double arrow) and ends as an obstructive apnea (effort present; green double arrow). Note the arousal (blue arrow) that terminates the apnea and the desaturation (purple arrow) that follows.
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Mixed sleep apnea. Note that the apnea (orange ar...

Mixed sleep apnea. Note that the apnea (orange arrow) begins as a central apnea (effort absent; red double arrow) and ends as an obstructive apnea (effort present; green double arrow). Note the arousal (blue arrow) that terminates the apnea and the desaturation (purple arrow) that follows.

A 2-minute recording of sleep showing 4 hypopneas...
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Media file 8: A 2-minute recording of sleep showing 4 hypopneas (thick arrows) and associated oxygen desaturations (red arrows). This recording illustrates the recurrent nature of the sleep-disordered breathing observed in many patients.
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A 2-minute recording of sleep showing 4 hypopneas...

A 2-minute recording of sleep showing 4 hypopneas (thick arrows) and associated oxygen desaturations (red arrows). This recording illustrates the recurrent nature of the sleep-disordered breathing observed in many patients.

Effect of nasal continuous positive airway pressu...
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Media file 9: Effect of nasal continuous positive airway pressure (CPAP) on oxygen saturation in sleep apnea. The upper portion of this figure shows the raw oxygen saturation trace from 1 night of a sleep study. Below the raw trace are vertical lines that indicate the presence of either an apnea or hypopnea. Before CPAP, frequent respiratory events with significant desaturations occurred. During the night, CPAP was applied, resulting in the elimination of the apnea and hypopneas and normalization of the oxygen trace.
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Effect of nasal continuous positive airway pressu...

Effect of nasal continuous positive airway pressure (CPAP) on oxygen saturation in sleep apnea. The upper portion of this figure shows the raw oxygen saturation trace from 1 night of a sleep study. Below the raw trace are vertical lines that indicate the presence of either an apnea or hypopnea. Before CPAP, frequent respiratory events with significant desaturations occurred. During the night, CPAP was applied, resulting in the elimination of the apnea and hypopneas and normalization of the oxygen trace.

Examples of good (upper panel) and poor (lower pa...
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Media file 10: Examples of good (upper panel) and poor (lower panel) compliance. In the upper panel, the patient is using continuous positive airway pressure (CPAP) most nights and generally for more than 4 hours (solid black line). In the lower panel, the patient is using CPAP infrequently and, when used, is wearing the CPAP device for less than 4 hours.
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Examples of good (upper panel) and poor (lower pa...

Examples of good (upper panel) and poor (lower panel) compliance. In the upper panel, the patient is using continuous positive airway pressure (CPAP) most nights and generally for more than 4 hours (solid black line). In the lower panel, the patient is using CPAP infrequently and, when used, is wearing the CPAP device for less than 4 hours.

Approach to a patient with excessive daytime slee...
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Media file 11: Approach to a patient with excessive daytime sleepiness after treatment with nasal continuous positive airway pressure.
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Approach to a patient with excessive daytime slee...

Approach to a patient with excessive daytime sleepiness after treatment with nasal continuous positive airway pressure.

More on Obstructive Sleep Apnea-Hypopnea Syndrome

Overview: Obstructive Sleep Apnea-Hypopnea Syndrome
Differential Diagnoses & Workup: Obstructive Sleep Apnea-Hypopnea Syndrome
Treatment & Medication: Obstructive Sleep Apnea-Hypopnea Syndrome
Follow-up: Obstructive Sleep Apnea-Hypopnea Syndrome
Multimedia: Obstructive Sleep Apnea-Hypopnea Syndrome
References
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Further Reading

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Keywords

obstructive sleep apnea-hypopnea, obstructive sleep apnea-hypopnea syndrome, OSAHS, obstructive sleep apnea, apnea, snore, obesity complication, OSA, obstructive sleep apnea syndrome, OSAS, snoring, apneic sleep, sleep disorder, central sleep apnea, CSA, central breathing instability, continuous positive airway pressure, CPAP, apnea-hypopnea index, apnea-plus-hypopnea index, AHI, sleep-disordered breathing, sleep disordered breathing, uvulopalatopharyngoplasty, UPPP, excessive daytime sleepiness, EDS

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Contributor Information and Disclosures

Author

James A Rowley, MD, Associate Professor, Fellowship Program Director, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine
James A Rowley, MD is a member of the following medical societies: American Academy of Sleep Medicine, American College of Chest Physicians, American College of Physicians, and American Thoracic Society
Disclosure: Nothing to disclose.

Medical Editor

Gregory Tino, MD, Director of Pulmonary Outpatient Practices, Associate Professor, Department of Medicine, Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania Medical Center and Hospital
Gregory Tino, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and American Thoracic Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Gregg T Anders, DO, Medical Director, Great Plains Regional Medical Command , Brooke Army Medical Center; Clinical Associate Professor, Department of Internal Medicine, Division of Pulmonary Disease, University of Texas Health Science Center at San Antonio
Gregg T Anders, DO is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and American Thoracic Society
Disclosure: Nothing to disclose.

CME Editor

Timothy D Rice, MD, Associate Professor, Departments of Internal Medicine and Pediatrics and Adolescent Medicine, Saint Louis University School of Medicine
Timothy D Rice, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Physicians
Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD, Director, Division of Pulmonary and Critical Care Medicine, Director, Women's Guild Pulmonary Disease Institute, Executive Vice Chair, Department of Medicine, Cedars Sinai Medical Center; Professor of Medicine, David Geffen School of Medicine at UCLA
Zab Mosenifar, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, and American Thoracic Society
Disclosure: Nothing to disclose.

 
 
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