Indian Journal of Respiratory Care | July 2013 | Volume 2 | Issue 2 277 Practcal approach to sleep disordered breathing Anup Bansal, Arun Samuel Ponnish, Nagarajan Ramakrishnan* Email: ram@nithra.com How to cite this article: Bansal A, Ponnish AS, Ramakrishnan N. Practical approach to sleep disordered breathing. Ind J Resp Care 2013; 2:277-83. Continuing education article reduction in airflow (< 50%) with desaturation (> 3%), or a moderate reduction in airflow (< 50%) with EEG evidence of arousal. 2 Classifcation There are three types of sleep apnoea: Obstructive (OSA), Central (CSA) and complex or mixed sleep apnoea. Sleep apnoea is called as obstructive when respiratory effort is present and central when effort is absent. Regardless of type, most of the time an individual with sleep apnoea may be unaware of his breathing problem. The condition is often noticed by bed partners or others who witness and vividly describe the episodes. It is not uncommon for the patient to deny any problem initially although they usually admit to symptoms upon further specific questioning. Common symptoms reported by patients are dryness of throat, a sense of tiredness or fatigue, drinking excessive caffeinated beverages to keep awake and remaining irritable or sleepy during the daytime. The symptoms also include difficulty in staying awake or falling asleep during common situations such as watching television, reading and driving etc, difficulty in concentration and controlling emotions, sometimes being aware of their own snoring and Introduction Sleep related breathing disorders are classified into three categories as per international classification of sleep disorders. 1 They are obstructive sleep apnoea (OSA) syndromes, central sleep apnoea (CSA) syndromes and sleep related hypoventilation/ hypoxia syndromes. Sleep disordered breathing is an important public health problem with significant health consequences for affected individuals. It is characterised by repetitive airflow cessation (apnoea) or reduction in airflow (hypopnoea) during sleep. It occurs when forces promoting airway collapse overcome mechanism that maintains airway patency. Apnoea is defined as cessation of airflow for ≥ 10 s in adults and 6 seconds or more in children. Over years, it has been observed by clinicians and researchers that hypopnoea has a similar impact on sleep. However, the definition has varied over a period of time. The consensus conference (Chicago Criteria) is now widely accepted and defines a respiratory event as hypopnoea if it meets one of the following criteria: Substantial reduction in airflow (> 50%), a moderate N. Ramakrishnan, AB (Int Med), AB (Crit Care), MMM, FACP, FCCP, FCCM Director, Nithra Insttute of Sleep Sciences, Number 29 (Plot Number 1997), J Block, 13th Main Road, Anna nagar, Chennai 600 040 abstract It is not uncommon to have occasional difficulty in falling asleep or have fatigue and day time sleepiness. However, when sleep disturbances persist for over a month and are associated with significant daytime dysfunction for at least two weeks, it may be a warning of an underlying sleep disorder requiring further evaluation and treatment. The combination of snoring, nonrefreshing sleep and daytime sleepiness is usually a hallmark of Obstructive Sleep Apnea (OSA) which is the most common sleep related breathing disorder. This review article aims to provide a practical and comprehensive approach to the diagnosis and management of sleep related breathing disorders with a focus on OSA. Keywords: Obstructive, polysomnography, sleep apnoea. [Downloaded free from http://www.ijrc.in on Tuesday, November 15, 2022, IP: 122.180.177.97]