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Pulmonary > 3.2.2 Sleep Apnea > Flashcards

3.2.2 Sleep Apnea Flashcards

1
Q

How do the hypoxia/hypercarbia responses during sleep compare to responses during waking hours?

A

Less responsive, the least responsive during REM sleep

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2
Q

What are some of the daytime symptoms of sleep apnea?

A
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3
Q

What does the graph represent?

A

A typical progression through sleep

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4
Q

Who does Miles know that wears a CPAP at night?

A

His dad…. How could you not know that? He’s probably told you at least 20 times.

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5
Q

What are some of the physical correlations with OSA from the clinical examination?

A
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6
Q

What is hypopnea?

A

Reduction in airflow associated with at least 3-4% drop in O2 Sat

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7
Q

What type of breathing is present during REM sleep?

A

Irregular

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8
Q

Where are the retro-palatal and retro-glossal regions?

A
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9
Q
A
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10
Q

What are some of the predisposing factors of OSA and their odds ratios?

A
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11
Q

How are cardiovascular physiology values changed during NREM sleep?

A

HR, BP, CO, and SVR are all decreased, thus reducing myocardial workload. This a result of parasympathetic discharge combined with a reduce in central sympathetic discharge.

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12
Q

Describe the mechansims/pathways that sleep apnea can lead to CV complications.

A
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13
Q

What acts as the central control of ventilation during sleep?

A

respiratory neurons of the medulla and pons

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14
Q

Where does OSA commonly manifest in patients?

A

Narrowing in retro-palatal and and retro-glossal regions

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15
Q

During which phase of sleep do most parasomnias occur?

A

N3

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16
Q

Which phase of sleep requires the loudest tone to wake up and most obnoxious stimuli to awake?

A

N3

17
Q

Deep sleep occurs during which stage?

A

N3

18
Q

What are some characteristics of the REM respiratory pattern?

A
19
Q

What are the stages of sleep? What are some major characteristics of stage?

A

Stage 1 (N1): low V, mixed frequency (theta), <50% alpha (wake)

Stage 2 (N2): predominately theta w/ sleep spindles or K complexes

Stage 3/4 (N3): large delta waves (stage 3 is 20-50%, stage 4 is >50%)

REM: atonia or flat EMG, irregular breathing pattern and phasic eye movements

20
Q

What is the label of the bracketed area?

A

Apnea

21
Q

What is the NREM respiratory pattern?

A
22
Q

Describe how the airflow and respiratory effort graphs of both central and obstructive apnea would look on a time strip.

A
23
Q

What are different levels of severity of OSA and their corresponding numbers of events in an hour?

A
24
Q

What are some of the cardio/cerebrovascular complications of OSA?

A
25
Q

What is central apnea?

A

No airflow and no respiratory effort for 10 seconds or longer

26
Q

What are some of the clinical features of OSA?

A
27
Q

What are some treatment options for OSA?

A
28
Q

What stage of sleep is shown in these graphs?

A

NREM

29
Q

Spontaneous arrousals have what effect on cardiovascular physiology?

A

Acute increases in HR, BP, CO, SVR much above the level of the awake state

30
Q

What stage of sleep is shown in the graphs below?

A

REM

31
Q

Describe the cardiovascular physiological state during REM sleep.

A

Unstable; Phasic REM results in flucuation in HR, BP, and SVR

32
Q

What two metabolic dysfunctions have been associated with sleep apnea?

A

Glucose intolerance and insulin resistance

33
Q

What is the gold standard of treatment for OSA?

A

CPAP

34
Q

What is obstructive apnea?

A

No airflow with obstructed respiratory effort for 10 seconds or longer

35
Q

What is apnea?

A

No airflow for 10 seconds or longer

36
Q

What are some of the risk factors for OSA?

A

OBESITY and Age of >65

Pulmonary (42 decks)

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