Apnea

Definition

Apnea is the absence of breathing for 10 or more seconds in adults or 20 or more seconds (or any duration with bradycardia/desaturation) in infants. Brief apneic episodes may be physiologic, but sustained apnea is an emergency.

Types and Causes

• Obstructive sleep apnea (OSA): Upper airway collapse during sleep.
• Central apnea: Loss of respiratory drive (CNS injury, opioid overdose).
• Mixed apnea: Combination of obstructive and central.
• Apnea of prematurity: Immature respiratory center in neonates.

Clinical Presentation

Loud snoring with witnessed pauses (OSA), daytime somnolence, morning headaches, and cognitive impairment. Neonates may present with bradycardia and cyanosis.

Nursing Interventions

Position airway (head-tilt chin-lift), provide supplemental oxygen, initiate bag-valve-mask ventilation if needed, and call rapid response. For chronic OSA, educate on CPAP adherence, weight loss, side-sleeping, and alcohol/sedative avoidance. Post-op apnea monitoring is critical for patients on opioids.

NCLEX Relevance

Recognize apnea as a respiratory emergency requiring immediate intervention. OSA and post-op sedation scenarios are high-yield.