Abnormal ventilatory control and sleep apnea Flashcards
apnea + hypopnea/ hour of sleep
this is a measure of sleep disturbance
AHI
sequence of breaths (for >10s) with decrease effort and arousal (but not apnea or hypopnea)
RERA
> 30% decrease of airflow (for >10s) plus decrease of SpO2 of > 3% or arousal from sleep
hypopnea
complete lack of airflow for >10 s
apnea
what happens to PaO2 and PaCO2 in OSA
there is a decrease in PaO2 (SaO2 also goes down) and PaCO2 increases
there is also arousal from sleep
OSA id a obstructive or restrictive disease
obstructive
there is both apnea and hypopnea
prevalence is higher in (4)
- males
- older age
- higher BMI
- those that snore
will benzodiazepines decrease OSA if taken before going to bed?
NOPE; makes it worse
major consideration of OSA in children
look at the tonsils
what happens in OSA during sleep
collapsing of the upper airways that can be due to because of gravity, decrease in lung volume when in supine, effect of negative pressure with inspiration, and muscle activity of UA dilator decreases
what is the biggest issue of the repeated arousal caused in OSA?
catecholamine surge that occurs with the increase activation in the sympathetic division
clinical manifestation of OSA (4)
- snoring
- hypersomnolence in day (watch out for them while driving)
- nocturnal chocking
- non-restorative sleep
complications of OSA (5)
- GERD
- pulm. hypertension
- metabolic syndrome
- cardiovascular mortality increases
- hypertension (50%)
how can we dx. OSA?
only during a sleep study!
- PSG
Tx: of OSA (6)
- CPAP
- weight loss
- change in sleep position
- avoid alcohol and benzos
- oral appliances
- upper airway surgery (really only in peds)
