Breathing disorders and sleep Flashcards
What stage has the most snoring
N3
Catathrenia
- inspiration or expiration
- side effect of what medicine
- what does it look like on a PSG
Expiration
Sodium Oxybate
CSA
What sleep disorder does high altitude cause and why
Periodic breathing (CSA) due to increased ventilatory chemoresponsiveness
- this causes daytime hyperventilation causing hypocapnea
- this in turn causes sleep time hypoventilation and periodic breathing
How does Pcrit relate to airway collapse and what stage is it highest?
Pcrit is the critical pharyngeal closing pressure
The higher Pcrit, the higher the chance of airway collapse
Highest during REM
At what stage of sleep is CSA of prematurity worse
REM sleep
What is the length of the apnea cycle in high altitude periodic breathing
20-40 seconds
What sleep stage is increased in high altitude periodic breathing?
N1
Criteria for OHS
obesity BMI>30kg/m2. Hypoventilation while awake measured by PaCO2 >45, ETCO2 or transcutaneous CO2 >45, and there should be absence any pulmonary pathology, or CNS disease, medication use or congenital or idiopathic central alveolar hypoventilation syndrome.
When does primary CSA of prematurity resolve?
43 weeks conceptional age
congenital central alveolar hypoventilation syndrome (CCHS)
- dominant or recessive
- gene responsible
Dominant
PHOX2B
congenital central alveolar hypoventilation syndrome (CCHS)
- associated with what cardiac issues?
- associated with what GI sisues
arrhythmias, may need pacemaker
Hirschsprung disease
rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD)
- what age does it start
- what hormone is high
- how does it affect the heart
Symptoms usually start at 18 months of age
Rapid weight gain
High prolactin
Arrhythmias
What stage of sleep is CSR usually seen
Transition from wake to NREM
Criteria to score CSR
Crescendo-decrescendo respirations that occur >3x for at least 40 seconds
How is the length of CSR related to cardiac output
The longer the CSR length, the worse cardiac complications
When does the arousal occur in OSA?
At apnea termination
When does arousal occur during CSR?
Peak of crescendo pattern
Leptin and OHS
Leptin is higher in ppl with OHS because leptin rises to increase ventilation
Kussmaul Breathing
rapid deep breathing at consistent pace. Common example is DKA
think Kussmaul for dKa
Apenustic Breathing
It is characterized by regular deep inspirations with an inspiratory pause followed by inadequate expiration
- caused by Pontine injury (stroke, trauma)
think aPneustic for Pons
Biots Breathing
Ataxic breathing CSA, seen with opioid use
Criteria for hypoventilation in adults
PaCO2 > 55mm Hg for 10 minutes
OR
An increase in PaCO2 greater than 10 mm Hg than baseline reaching > 50mm Hg for 10 minutes
Area of pharynx with highest collapsibility in OSA
retropalatal area
