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Obstructive Sleep Apnea (OSA)

Recall obstructive sleep apnea (OSA) by the image of the obstructed sleeping ape who needs air. This condition is caused by narrowing or obstruction of the air passage during sleep, shown by the narrowed and obstructed air passage of the ape. The ape needing air represents apnea. Apnea is described as a cessation in spontaneous breathing that lasts for greater than 10 seconds per episode. Many patients will also experience loud snoring, shown by the ape&rsquo;s loud snore-ring. Snoring occurs when tissues in the throat relax and partially block the airway, causing the characteristic vibrating sound. Patients can become hypercapnic due to periods of apnea, and when this occurs, a startle response is triggered, shown by the startling jack-in-the-box. This is often manifested as a snort or a gasp, which allows the tongue and soft palate to fall forward, thereby reopening the airway. Due to these frequent interruptions in sleep, patients may experience daytime sleepiness, shown by the ape in a state of daytime sleepiness. The ape is so tired of all these symptoms, he sets out to find a way to get better. Interventions to help reduce or eliminate episodes of apnea may include positional therapy, shown by the positional bed. Changing sleeping positions by sleeping to the side, or elevating the head of the bed can help reduce episodes of apnea. An oral appliance such as a mouth guard may be used to help prevent obstruction of the patient&rsquo;s airway by shifting the jaw and tongue forward. This is shown by the oral appliance the ape is placing in his mouth. In patients with severe sleep apnea, continuous positive airway pressure or CPAP may be necessary. This is illustrated by the ape with his CPAP machine. An alternative intervention called bilevel positive airway pressure or BiPAP can also be used. This type of therapy may be better tolerated by patients due to a higher inspiratory pressure, and lower mean pressure during expiration. When non-surgical interventions are ineffective,&nbsp;surgery may be indicated to treat sleep apnea. This is shown by the surgeon operating on the ape. Lastly, patients with sleep apnea should be encouraged to lose weight, shown by the skinny ape with baggy-pants, as being &nbsp;overweight or obese worsens this condition. So to review obstructive sleep apnea, remember that it is caused by narrowing or obstruction of the air passage during sleep. A patient diagnosed with this disorder may experience the following symptoms: frequent apnea, loud snoring, startle response, and daytime sleepiness. Interventions to treat this condition include changing the patient&rsquo;s sleeping position, use of an oral appliance such as a mouth guard, CPAP, BiPAP, or surgical interventions. Patients with sleep apnea should be encouraged to lose weight, as being overweight or obese worsens sleep apnea.

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Obstructed Sleeping Ape-needs-air

Sleep Disorders

Intern Content - Secondary Hypertension

Sleep apnea

Obstructive sleep apnea

Obstructive Sleep Apnea Explained Clearly - Pathophysiology, Diagnosis, Treatment

Sleep Apnea

Cause/Mechanism

narrow and obstructed airway.png

Narrowed and Obstructed Air Passage

Narrowed or Obstructed Air Passage

Which of the following is most likely a cause of obstructive sleep apnea?

Assessment

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Ape-needs-air

Apnea

Which of the following is most likely a clinical feature of obstructive sleep apnea?

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Loud Snore-ring

Loud Snoring

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Startling Jack-in-the-box

Startle Response

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Daytime Sleepiness

Daytime Drowsiness

Interventions

positional bed.png

Positional-bed

Positional Therapy

Which of the following is the most appropriate intervention used in the management of obstructive sleep apnea?

oral appliance.png

Oral Appliance

CPAP.png

CPAP

Continuous Positive Airway Pressure (CPAP) 

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Surgeon

Surgery

Considerations

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Skinny with Baggy-pants

Weight Loss

Which of the following is the most appropriate recommendation in a patient with obstructive sleep apnea?

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Potter, Perry, Stockert & Hall, 2017, Fundamentals of Nursing, 9th Ed.

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Due to an obstructive sleep apnea, this sleeping ape-needs-air. &nbsp;His air passage is narrow and obstructed by his uvula, so the air can't pass. &nbsp;He's without breath, which is called apnea, the reason this ape-needs-air. &nbsp;As he tries to force air passed the obstruction, it results in loud snoring, as a snore-ring on his nose starts to vibrate. &nbsp;After going without breath for some time, a jack-in-the-box wakes him up, kind of like an alarm, causing a startling response when he jerks up in bed. &nbsp;It's nearly impossible for him to get a good nights sleep while struggling to breathe, so he's always sleepy at his daytime job. &nbsp;After this carried on for quite some time, he decided to do something about it. &nbsp;He bought a positional-bed, which encouraged him to sleep in different positions. &nbsp;And then he put an oral appliance in his mouth to pull his jaw forward. &nbsp;When the sleepless nights persisted, he took things a step further and put on a CPAP, which continuously provided him with positive air pressure all night. &nbsp;While this helped him to breath, he now found it hard to sleep with a strange device strapped to his face. &nbsp;He decided to take drastic measures and went in for surgery. &nbsp;And as the ape surgeon put him under, he was finally able to able dream for the first time in a long time. &nbsp;He dreamed about losing weight when this was all over. &nbsp;If he could at last get some sleep, he knew he could become the ape he always wanted to be.

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Picmonic NCLEX Question of the Day 05/14/2022

Picmonic NCLEX® Question of the Day

A 54-year-old male reports daytime sleepiness. During your assessment, you find that he is morbidly obese. His wife reports that he is a loud snorer. Which of the following would you expect the patient to be treated for?

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