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| ==Overview== | | ==[[Hypopnea overview|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.
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| ==Pathophysiology== | | ==[[Hypopnea historical perspective|Historical Perspective]]== |
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| The direct consequence of hypopnea (as well as apnea) is that the CO<sub>2</sub> 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.
| | ==[[Hypopnea pathophysiology|Pathophysiology]]== |
| ==Classification== | |
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| 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).
| | ==[[Hypopnea causes|Causes]]== |
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| | ==[[Hypopnea differential diagnosis|Differentiating Hypopnea from other Diseases]]== |
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| | ==[[Hypopnea epidemiology and demographics|Epidemiology and Demographics]]== |
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| == Causes == | | ==[[Hypopnea risk factors|Risk Factors]]== |
| Among the causes of hypopnea there are:<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
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| *anatomical defects such as [[deviated septum|nasal septum deformation]] or congenital narrowness of nasal meati and the gullet,
| | ==[[Hypopnea natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| *[[overweight]] and [[obesity]],
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| *[[neuromuscular disease]] or any condition that entails weakened [[diaphragm (anatomy)|respiratory muscles]]
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| *use of [[sedatives]] (sleeping pills, etc.),
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| *[[alcohol abuse]],
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| *[[tobacco smoking|smoking]],
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| *[[aging]],
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| and some others that are typical of [[snoring]] and [[sleep apnea]].
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| == Symptoms == | | ==Diagnosis== |
| 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.
| | [[Hypopnea history and symptoms|History and Symptoms ]] | [[ Hypopnea physical examination|Physical Examination]] | [[Hypopnea laboratory findings|Laboratory Findings]] | [[Hypopnea electrocardiogram|Electrocardiogram]] | [[Hypopnea chest x ray|Chest X Ray]] | [[Hypopnea echocardiography or ultrasound|Echocardiography or Ultrasound]] |
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| 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.
| | ==Treatment== |
| | [[Hypopnea medical therapy|Medical Therapy]] | [[Hypopnea surgery |Surgery]] | [[Hypopnea primary prevention|Primary Prevention]] | [[Hypopnea secondary prevention|Secondary Prevention]] | [[Hypopnea cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Hypopnea future or investigational therapies|Future or Investigational Therapies]] |
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| == Complications == | | ==Case Studies== |
| 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.
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| Cardiovascular consequences of hypopnea include myocardial infarction, stroke, psychiatric problems, impotence, cognitive dysfunction, hypertension, coronary heart disease, and memory loss.
| | [[Hypopnea case study one|Case #1]] |
| ==Laboratory Findings==
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| 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) [[pulse oximetry|desaturation in the person's O<sub>2</sub> levels]] for 10 seconds or longer, or if it results in arousal or fragmentation of sleep.
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| == Treatment ==
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| The most common treatment for hypopnea is continuous positive airway pressure ([[CPAP]]). CPAP is a treatment in which the patient wears a mask over the nose and/or mouth. An air blower forces air through the upper airway. The air pressure is adjusted so that it is just enough to avoid the upper airway tissues from collapsing during sleep but apnea episodes return when CPAP is stopped or it is used improperly. For people with neuromuscular disorders the most common treatment is the use of BIPAP or other non-invasive ventilation.
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| Mild hypopnea can often be treated by losing weight or by avoiding sleeping on one's back. Also quitting smoking, refusal from alcohol, sedatives and soporifics before sleep can be quite efficient. Certain physical exercises that strengthen gullet muscles also bring some results in hypopnea treatment.
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| ==Surgery== | | == Related Chapters== |
| 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.
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| ==References==
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| {{Reflist}}
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| == See also ==
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| *[[Sleep apnea]] | | *[[Sleep apnea]] |
| *[[Sleep disorder]] | | *[[Sleep disorder]] |
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| [[ca:Hipopnea]]
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| [[es:Hipopnea]] | | [[es:Hipopnea]] |
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| [[Category:Neurology]] | | [[Category:Neurology]] |
| [[Category:Sleep disorders]] | | [[Category:Sleep disorders]] |
| [[Category:Signs and symptoms]]
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| {{WH}} | | {{WH}} |
| {{WikiDoc Sources}} | | {{WikiDoc Sources}} |