CASE STUDY 2 |
54 year old man, truck driver, snorer, observed apneas. License revoked due to excessive daytime sleepiness. Referred to UBC for investigation.
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His sleep efficiency and sleep maintenance efficiency were 68.8 % and 77.5 %, respectively. He had no Stage 3 or 4 sleep.
Subjectively, he says that he did not get his usual sleep on the night of the polysomnogram. |
He was told that he did not have OSA. His license was reinstated. However, his wife remained concerned about his apneas and he continued to complain of excessive sleepiness and fatigue.
On presentation, his Epworth score was 12.
Dynamic Nasopharyngoscopy
Shallow velopharynx, bifid uvula, marked collapse with Muller's maneuver, airway dilates with jaw thrust.
Resting airway |
With Muller's maneuver |
With jaw thrust |
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Patients that show this degree of airway collapse on Muller's maneuver invariably have clinically significant Obstructive Sleep - Disordered Breathing. A limited ambulatory sleep study was obtained.
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The limited ambulatory sleep study showed Severe OSA occurring when supine (as shown above), and Mild OSA when lying on his sides. Although a dental appliance would have been effective, his insurer only provided coverage for CPAP.
Treatment was initiated with CPAP at a pressure of 7. His Epworth score on CPAP is 9 and he reports increased energy and alertness.
Case Study 1:| Home | Snoring & Sleep Apnea | Treatments | Effects of Treatment |
