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Rated: 18+ · Article · Medical · #2270547
Treating sleep apnea, why it's important, and how to help clients use their PAP machine.
Millions of Americans suffer with undiagnosed obstructive sleep apnea (OSA). with as many as 56 percent of older adults, aged 65 or more, being at high risk of sleep apnea, but with only 8 percent having been tested, according to Michigan Health Lab researchers.1{/super} A study published in the Journal of the American Geriatric Society looked at 1,052 adults age 65 or over. Of those, 56% were deemed to be at high risk for OSA, yet only 8% had been tested. But of those 8% tested, 94% had been diagnosed with OSA.2

Sleep apnea is when, while sleeping, you stop breathing at least an average of 5 times per hour for a minimum of 10 seconds and your blood oxygen levels drop. Mild sleep apnea is when you stop breathing for an average of 5-15 times per hour. Moderate sleep apnea is defined as 16-30 times per hour. Severe sleep apnea is when you stop breathing and your oxygen levels drop more than 30 times per hour.3

There are several types of sleep apnea, but we will be discussing obstructive sleep apnea where the airway is obstructed, typically by the relaxed tongue and/or soft palate. While this can happen to anyone at any age, it is most common in overweight people and older adults as muscle tone decreases can increase the risk of OSA. But it's important to remember that age and weight are only risk factors. Thin and young people (including 2% of children3) have OSA as well. In some cases, it's simply how their mouth and throat were built. Enlarged tonsils, a narrow throat, a large tongue or tongue that is further back in their throat are some of the possible structural risk factors. (Find citation for this. #3 is the citation for the narrow throat) But whatever the cause, as many as 90% of people with sleep apnea don't know they have it while it may well be slowly killing them as it can cause and/or contribute to numerous serious health conditions.3

In a cycle of sleep apnea, the person falls asleep, their body relaxes, causing the beginning of their airway to be blocked. They then usually being to snore, often loudly, then as they fall deeper into sleep, they relax more and their airway often becomes completely blocked. They stop breathing and their oxygen levels in their blood begin to drop. Eventually, sometimes as much as a minute or more later, their brain rouses them enough to pull them out of their current sleep cycle and wake them so that they can begin breathing again.

Often the individual isn't even aware that they've been awakened, but their sleep cycle has been disrupted, causing sleepiness and other problems the next day due to the poor quality of their sleep. After being aroused enough to begin breathing, they then begin to fall back into a deeper sleep again and the cycle continues--falling asleep, the airway becomes blocked, they stop breathing, their oxygen begins to drop, their brain wakes them again...over and over and over.

what types of problems can it cause
what happens when people don't use it--death rates
risk factors--don't use them as the only reason to refer
how often to be reassessed, change equipment, clean it, etc.
what to do when you have a client who needs to use their PAP but doesn't want to


Hypopnea is when the breathing is reduced so much that oxygen levels drop. Apnea is when breathing is stopped completely. OSA is rated on a scale called the Apnea-Hypopnea Index or AHI. It measures the number of apnic and hypopnic episodes per night.3

1 https://labblog.uofmhealth.org/lab-report/osa-older-adults-often-present-seldom-...
2 https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.15372 https://doi.org/10.1111/jgs.15372
3 https://www.hopkinsmedicine.org/health/conditions-and-diseases/obstructive-sleep...
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