Chapter 20- Disorders of Respiratory Control

Question 1

Diverse group of conditions in which physiologic variations are heightened resulting in abnormal respiratory function and fragmented sleep

Answer 1

sleep disordered breathing

Question 2

complete cessation of airflow >10 sec

Answer 2

apnea

Question 3

significant decrease in airflow

Answer 3

hypopnea

Question 4

What is the most common sleep apnea syndrome?

Answer 4

obstructive sleep apnea (OSA)

Question 5

What happens in OSA?

Answer 5

upper airway relaxation occludes the airway during sleep causing cessation of airflow –> results in recurring episodes of hypoxemia

Question 6

Sleep apnea is the most identifiably common cause of _______

Answer 6

HTN

Question 7

Do OSA patients have increased rate of stroke and CAD in OSA patients?

Answer 7

yes

Question 8

S/S of OSA

Answer 8

Pt complains of lack of refreshing sleep
Morning HA, recurrent awakenings, daytime somnolence that affects daytime activities
Complaints of snoring and gasping episodes from sleeping partners

Question 9

What heightens the symptoms of OSA?

Answer 9

recent weight gain
sedatives
sleeping pills
ETOH

Question 10

Are chest radiographs and PFTs helpful in diagnosis of OSA?

Answer 10

NO

Question 11

What helps diagnose OSA?

Answer 11

overnight polysomnography w/ continuous ECG and EEG tracings

Question 12

What will ABG and CBC show?

Answer 12

ABG: hypoxemia and hypercapnia
CBC: polycythemia

Question 13

What is the treatment for OSA?

Answer 13

weight loss, avoid sedatives/ETOH, CPAP, removal of enlarged tonsils/adenoids/polyps, permanent tracheostomy if severe

Question 14

What is an abnormal breathing that occurs in men of normal body habitus and is due to decreased central respiratory drive?

Answer 14

central sleep apnea

Question 15

What are symptoms of central sleep apnea?

Answer 15

daytime sleepiness, insomnia with frequent awakenings, may hypoventilate when awake

Question 16

Sleep problem caused by lower brainstem and upper pontine lesions. Also caused by hepatic cirrhosis, extreme anxiety, pregnancy

Answer 16

Central hyperventilation

Question 17

What is sustained respiratory pauses resulting from damage to the mid-pons (i.e. basilar artery infarction)?

Answer 17

Apneustic breathing

Question 18

What is haphazardly random pattern of sleep characterized by shallow breaths?

Answer 18

Biot respiration (Ataxic breathing)

Question 19

What are cheyne-stokes respirations?

Answer 19

regular cycling of crescendo-decrescendo tidal volumes separated by apneic or hypopneic pauses
Typically seen with HF or CNS disease