Chronic Obstructive Sleep Apnea

Question 1

Essentials of Diagnosis of what?

(1) Daytime somnolence or fatigue.
(2) History of loud snoring with witnessed apneic events.
(3) Overnight polysomnography demonstrating apneic episodes with hypoxemia.

Answer 1

Chronic obstructive sleep apnea

Question 2

These clinical risk factors are for what?
(a) Advancing age
(b) Male Gender
(c) Obesity
(d) Craniofacial morphology or upper airway soft tissue abnormalities.
(e) Additional factors identified in some studies include smoking, nasal congestion,
menopause, and family history.

Answer 2

Chronic Obstructive Sleep Apnea

Question 3

True/False
Rates of OSA are decreased in association with medical conditions, such as pregnancy, end-stage renal disease, congestive heart failure, chronic lung disease, posttraumatic stress disorder, and stroke

Answer 3

False

Rates are increased

Question 4

True/False

Menopausal women appear to have a decreased risk of OSA compared with premenopausal women, independent of age and BMI.

Answer 4

False

increased risk

Question 5

True/False

Smoking appears to increase the risk of OSA or at least aggravate preexisting symptoms.

Answer 5

True

Question 6

Patients with OSA often report a family history of ____ or _______.

Answer 6

snoring or OSA

Question 7

True/False
Craniofacial and upper airway soft tissue abnormalities each increase the likelihood of having or developing OSA.
-This best recognized in Asian patients where
obesity is not as obvious an issue

Answer 7

True

Question 8

True/False
While a variety of substances and medications, including alcohol, benzodiazepines, and narcotics, may alleviate OSA, a causative link is unproven.

Answer 8

True

Question 9

What is the questionnaire used by used by sleep apnea screeners?

Answer 9

STOP BANG Questionnaire

Question 10

What does the STOP stand for in the STOP BANG OSA questionnaire?

Answer 10

(a) S (Snore): Yes or No
(b) T (Tired):
1) Do you feel fatigued during the day?
2) Do you wake up feeling like you haven’t slept?
(c) O (Obstruction):
1) Have you been told you stop breathing at night?
2) Do you gasp for air or choke while sleeping?
(d) P (Pressure):
1) Do you have blood pressure or on medications of high blood pressure?

Question 11

What does the BANG stand for in the STOP BANG OSA questionnaire?

Answer 11

B (BMI):
  - Is your BMI>28
A (Age):
   - Are you older then 50
N (Neck):
   - For males is you neck> 17 inches, For females is your neck>16 inches
G (Gender):
   - Are you a male

Question 12

If you answer is YES to ___ or more questions (categories) then you are high risk of having OSA and require referral for a sleep study.

Answer 12

three

Question 13

Off of the OSA Questionnaire what is considered low risk of having OSA.

Answer 13

Answer YES to less than 3 questions

Question 14

For low risk OSA when you can refer for a sleep study?

Answer 14

if there is other information that makes the diagnosis more likely to be OSA,

Question 15

What is the first line diagnostic study when OSA is suspected?

Answer 15

In-laboratory polysomnography

Question 16

What are some DDx for OSA

Answer 16

Those that include conditions that produce disrupted sleep and/or excessive daytime sleepiness.
(alone or in combination)
-loud snoring without OSA
-insufficient sleep or circadian rhythm disturbances
-periodic limb movements of sleep
-central sleep apnea
-primary respiratory disease

Question 17

True/False
The maximum benefits of positive airway pressure therapy are realized when patients use their devices randomly during sleep. CPAP use should be routinely determined using objective criteria and monitored sequentially over time.

Answer 17

False

Better results when regularly used during sleep

Question 18

What are some Tx for OSA

Answer 18

(1) CPAP
(2) Weight loss.
(3) Oral appliances.
(4) Upper airway surgery.

Question 19

What are some complications of OSA

Answer 19

(1) Motor vehicle crashes.
(2) Cardiovascular morbidity.
(3) Metabolic syndrome and type 2 diabetes
(4) Nonalcoholic fatty liver disease.

Question 20

True/False

For OSA you should subscribe Ambien 1 tablet 50mg every evening for two weeks to your patients to help them sleep.

Answer 20

False

No Meds are indicated for OSA specifically… Treat the underlying causes