Snoring module

Differential diagnosis
Obstructive sleep apnea
Basis: Age 40year old
Male gender
BMI of 40 (obese)
Snoring and excessive daytime sleepiness
Hx of hypertension
Difficulty sleeping, wakes up at night due to sore throat and wakes up
feeling tired and without energy to last the day
Irritated and easily distracted
Loud snorer and change in position shows no relief
Asthma
Somnolence during driving
Upper airway resistance syndrome (UARS)
Basis: Snoring and excessive daytime sleepiness
Irritated and easily distracted
Loud snorer
Hx of Hypertension
Somnolence during driving
BMI of 40 (obese)
Obesity hypoventilation syndrome:
Basis: Poor sleep quality
Sleep apnea
Daytime sleepiness
Tiredness
Sleep disordered breathing
Sleep disordered breathing is present when there are
repetitive episodes of cessation of respiration (apnea) or
decrements in airflow (hypopnea) during sleep,
associated with a brief awakening.
It includes:
Snoring:- Snoring is one of the most common aspects
of SDB. It is defined by theRandom House Dictionary of
the English Languageas breathing during sleep with
hoarse or harsh sounds as caused by the vibrating of
the soft palate.
Upper Airway Resistance Syndrome:- Upper airway
resistance syndrome (UARS) is associated with
increasing negative intrathoracic pressure associated
with upper airway flow limitation, resulting in arousals
from sleep followed by EDS, but there is no apnea or
significant fall in SpO2. UARS is thought to be milder
form of OSA spectrum.
Obstructive sleep apnea hypopnea syndrome
(OSAHS):- Definition OSAHS is defined on the basis of
nocturnal and daytime symptoms as well as sleep study
findings. patient must have
( 1 ) either symptoms of nocturnal breathing
disturbances (snoring, snorting, gasping, or breathing
pauses during sleep) or daytime sleepiness or fatigue
that occurs despite sufficient opportunities to sleep
Delayed sleep phase syndrome
Delayed sleep phase syndrome is a disorder in which
the major sleep episode is delayed in relation to the
desired clock time, resulting in symptoms of sleep-onset
insomnia or difficulty in awakening at the desired time.
This syndrome is characterized by the persistent
occurrence of sleep at a later-than-desired time,
difficulty in awakening at a desired time, and sleepiness
several hours after awakening.
INSUFFICIENT SLEEP
Insufficient sleep syndrome occurs when the patient
regularly fail to get enough sleep at night. The result is
sleep deprivation.
It is voluntary but unintentional. The patient is unaware
that that he/she need more sleep than they are getting.
It also detects no medical reason to be sleepy and
mental exam reveals nothing abnormal.
NARCOLEPSY
Narcolepsy is characterized by : ( 1 ) sudden muscle weakness without a loss of
consciousness, which is usually triggered by strong emotions (2) dream like
hallucinations at sleep onset (hypnagogic hallucinations) or upon awakening
(hypnopompic hallucinations) ; and (3) muscle paralysis upon awakening (sleep
paralysis) .
In contrast to patients with disrupted sleep (e.g. sleep apnea), people with
narcolepsy usually feel well rested upon awakening and then feel tired Healthy
throughout much of the day.
Usually, the person is unable to control his falling asleep, no matter where he is.
While sleep apnea usually affects a person who is 40 or above, narcolepsy
usually start when a person is an adolescent.
Kleine-Levin Syndrome
Kleine-Levin Syndrome (KLS), also known as Sleeping
Beauty syndrome, is a rare neurological disorder
characterized by recurrent bouts of hyper somnolence
(excessive sleeping) along with cognitive and behavioral
problems during wakefulness.
It is characterized by hyper sexuality, Compulsive
eating (hyperphagia), Altered perceptions, Cognitive
impairment, Hypersomnia or excessive sleep (Patients
spend between 12 and 24 hours asleep and are difficult
to arouse from sleep.)
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