A Woman Whose Husband Died Has New-Onset Atrial Fibrillation and Fatigue

Asim Kichloo, MD; Nadir Siddiqui, MD; Nazir Lone, MD, MPH; Mohamed A. Mohamed, MD

Disclosures

September 04, 2020

The goals of OSA treatment are to decrease the frequency of apneic events during sleep and to normalize oxygen saturation levels. Achievement of these goals will eventually lead to fewer symptoms and long-term complications. Continuous positive airway pressure (CPAP) remains the treatment of choice for OSA; it has the greatest efficacy in reducing daytime sleepiness.[1] Patients with OSA should use CPAP for at least 4 hours each night.[29]

Unfortunately, a major roadblock in prescribing CPAP is low adherence owing to various factors, including lack of patient education, pressure sores, an intrusive mask, claustrophobia, and dry nasal mucous membranes. Newer models have a more compact, comfortable fit and humidification and air-heating capabilities.[30] However, patients require a retitration study before switching from an older model to a newer one.

Lifestyle modification, such as weight loss, exercise, and alcohol abstinence, shows promising results in managing OSA and should be implemented in conjunction with CPAP. Patients should also be advised to try positional therapies and not to sleep in a supine position.[1]

Oral appliances, such as mandibular advancement splints, have been used in the treatment of OSA; these devices are intended to keep the airway open during sleep. Surgical treatments are reserved for patients with certain types of airway obstruction.[1]

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