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Sleep Apnea, Emergency Medicine

Ajay Bhatt Reviewed 06/2017
 


Basics

Description

  • Disorder characterized by cessation of breathing during sleep:

    • Defined as apneic episodes >10 sec with brief EEG arousals or >3% oxygenation desaturation

  • Risk factors:

    • Obesity

    • Male

    • ...

Diagnosis

Signs and Symptoms

  • Excessive daytime sleepiness

  • Snoring

  • Irritability

History

  • Significant other apnea report

  • Difficulty sleeping

  • Decreased attention/concentration

  • Depression

  • Decreased libido/impotence

Physical Exam

Treatment

Pre-Hospital

Caution not to overventilate patient with chronic CO retention 

Initial Stabilization/Therapy

Chin lift/jaw thrust maneuver, oxygen as needed, oral or nasal airway devices 

Ed Treatment/Procedures

Follow-Up

Disposition

Admission Criteria

  • Ventilatory failure, especially if intubation is necessary

  • Hemodynamic instability

Discharge Criteria

  • Maintenance of O2 saturation >85% for several hours using o...

Pearls and Pitfalls

  • Sleep apnea increases risk of cardiovascular disease, stroke, and diabetes mellitus.

  • CPAP is the standard of treatment.

  • Avoid the use of sedatives.

  • Preparation is essential, as sleep ...

Additional Reading

  • Buchner  NJ, Sanner  BM, Borgel  J, et al. Continuous positive airway pressure treatment of mild to moderate obstructive sleep apnea reduces cardiovascular risk. Am J Respir Crit Ca...

Codes

ICD9

  • 327.21 Primary central sleep apnea

  • 327.23 Obstructive sleep apnea (adult)(pediatric)

  • 780.57 Unspecified sleep apnea

  • 327.29 Other organic sleep apnea

  • 327.27 Central sleep apnea in conditions clas...

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