Clinical Perspective of Sleep Apnea

Question 1

How do obstructive sleep apnea and hypopnea differ?

Answer 1

Apnea is the complete cessation of airflow. Hypopnea occurs when the patient is able to partially overcome the obstruction so airflow never fully ceases

Question 2

What factors are assessed with the STOP BANG score?

Answer 2

Question 3

True/False. Obese patients have chronic CO2 retention.

Answer 3

True - this is due to excess weight on the thorax. Obstructive sleep apnea may or may not be present.

Question 4

Cessation of breathing during sleep due to a transient absence of respiratory drive is termed…?

Answer 4

Central sleep apnea

Question 5

When does sleep apnea most commonly occur during sleep?

Answer 5

REM sleep

Question 6

True/False. Morning headaches and daytime sleepiness are a consequence of nocturnal hypoxemia.

Answer 6

False. These symptoms are associated with nocturnal hypercapnia.

Question 7

What is the first line treatment for obstructive sleep apnea?

Answer 7

Continuous positive airway pressure

Question 8

The apnea-hypopnea index can be used to distinguish mild, moderate, and severe sleep apnea. What is the number of apneas for each class?

Answer 8

Question 9

Recurrent nocturnal hypoxemia is associated with polycythemia. Why is this?

Answer 9

Nocturnal hypoxia stimulates EPO release

Question 10

Describe the pathophysiology of obstructive sleep apnea.

Answer 10

Reduced central output to upper airway muscles that maintain a patent airway. This increases airway resistance and thus the negative pressure that must be created for breathing. This increase in negative pressure further collapses the airway

Question 11

A STOP BANG score above what value indicates a high risk for severe obstructive sleep apnea?

Answer 11

5 or more