Harrison's PodClass: Internal Medicine Cases and Board Prep Ep 145: A 45-Year-Old Snorer
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May 8, 2025 A 45-year-old man's struggle with worsening snoring highlights the serious world of sleep apnea. The podcast dives into the differences between obstructive and central sleep apnea, exploring diagnostic criteria and treatment options. Key discussions include the importance of polysomnography for diagnosis and the interplay between obesity and sleep apnea. The impact of sleep apnea on cardiovascular health is emphasized, along with lifestyle changes and the effectiveness of CPAP therapy in improving quality of life.
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45-Year-Old Suspected Sleep Apnea
- A 45-year-old man's worsening snoring and breathing pauses alarm his spouse, suggesting possible sleep apnea.
- The spouse's discomfort is severe enough to cause her to sleep in another room sometimes.
Understanding Sleep Apnea Types
- Obstructive sleep apnea (OSA) involves apnea with inspiratory effort, unlike central sleep apnea.
- OSA results from airway collapse due to reduced neurologic tone during sleep, causing fragmented breathing.
Best Diagnostic Approach for OSA
- Diagnose OSA with an overnight polysomnogram, the gold standard, as symptoms alone are unreliable.
- Follow up a negative home sleep test with a full polysomnogram if suspicion remains high.
