Hypopnea

Jump to navigation Jump to search
Hypopnea

Hypopnea Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hypopnea from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Echocardiography or Ultrasound

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hypopnea On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hypopnea

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hypopnea

CDC on Hypopnea

Hypopnea in the news

Blogs on Hypopnea

Directions to Hospitals Treating Hypopnea

Risk calculators and risk factors for Hypopnea

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Hypopnea is a medical term for abnormally shallow breathing or slow respiratory rate. This differs from apnea in that there remains some flow of air. Hypopnea comes from the Greek roots hypo- (meaning low, under, beneath, down, below normal) and pnoe (meaning breathing). Literally it means underbreathing.

Pathophysiology

The direct consequence of hypopnea (as well as apnea) is that the CO2 in the blood increases and the oxygen level in the patient’s blood decreases proportionate to the severity of the airway obstruction. This disruptive pattern of breathing generates disruptive sleep patterns, the consequences of which being that those individuals exhibit increased fatigability, lethargy, decreased ability to concentrate, increased irritability, and morning headaches. Basically, those individuals are extremely tired due to their inability to get a good night’s sleep.

Classification

Hypopnoeas can be either central (i.e., as part of a waxing and waning in breathing effort) or obstructive in origin. During an obstructive hypopnoea, in comparison to an obstructive apnoea, the airway is only partially closed. However, this closure is still enough to cause a physiological effect (i.e., an oxygen desaturation and/or an increase in breathing effort terminating in arousal).


Causes

Among the causes of hypopnea there are:[1] [2]

and some others that are typical of snoring and sleep apnea.

Symptoms

The most common hypopnea symptom is excessive sleepiness, which results from constant sleep interruption. People with hypopnea often have loud, heavy snoring that is interrupted with choking sounds or loud snorts followed by periods of silence, because not enough air can flow into the lungs through the mouth and nose. The periods of silence can last 20 seconds or longer and can happen many times each hour, resulting in poor sleep and reduced levels of oxygen in the blood.

Other symptoms of hypopnea may include depression, forgetfulness, mood or behavior changes, trouble concentrating, loss of energy, nervousness, morning headaches. Not all people with hypopnea experience all of these symptoms and not everyone who has these symptoms has hypopnea.

Complications

Hypopnea is a disorder that results in excessive daytime sleepiness and compromised quality of life, including traffic accidents, diminished productivity in the work place and emotional problems.

Cardiovascular consequences of hypopnea include myocardial infarction, stroke, psychiatric problems, impotence, cognitive dysfunction, hypertension, coronary heart disease, and memory loss.

Laboratory Findings

In the diagnosis and treatment of sleep disorders, a hypopnea event is not considered to be clinically significant unless there is a 50% (or greater) reduction in flow and an associated 3% (or greater) desaturation in the person's O2 levels for 10 seconds or longer, or if it results in arousal or fragmentation of sleep.

Surgery

Also there's an operative method, i.e. surgery. Upper airway surgery is site-specific. Depending on the cause of obstruction it focuses on the soft palate, the uvula, tonsils, adenoids or the tongue. There are also more complex surgeries that are performed with the adjustment of other bone structures - the mouth, nose and facial bones. Surgery is actually the last thing that doctors recommend to resort to in hypopnea treatment. But sometimes it is the only choice when other options don't work.

References

  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

Related Chapters



ca:Hipopnea

Template:WH Template:WikiDoc Sources