EXAM #2: SLEEP RELATED BREATHING DISORDERS Flashcards
How long is the sleep cycle?
90-110 minutes
What are the two major stages of sleep?
1) Non-REM (1-4)
2) REM*
*Note that there is no muscle tone during REM sleep
What happens to TV during sleep? Specifically, what happens during REM and NREM sleep?
Generally, TV goes down
Specifically,
- NREM= 6-16% decrease
- REM= 25% decrease
What happens to airway resistance during sleep?
Resistance INCREASES by 230%
What is Obstructive Sleep Apnea (OSA)?
Dynamic airway narrowing or closure during sleep that is terminated by arousal
What causes OSA?
1) Decreased muscular tone
2) Crowding of the upper airway
What are the sx. of OSA?
1) Loud snoring*
2) Oxygen desaturation
3) Frequent arousal
*Note that this is inspiratory and expiratory
What are the risk factors for OSA?
1) Obesity (increased soft tissue)
2) Family hx.
3) Treatment resistant HTN
4) CHF, a-fib, CVA
5) DM-II
What are the two major screening tools for OSA?
1) Berlin questionnaire
2) STOP-BANG screening test
Is OSA more common in males or females?
Males
What is the most common cause of OSA in kids?
Adenotonsillar hypertrophy
*Note that many of these kids will have learning difficulties b/c of their sleep apnea
What is the Epworth Sleepiness Scale?
This is a measure to quantify sleepiness
What neck size puts a patient at risk for OSA?
Men= greater than 17'' Women= greater than 16''
What Mallampati score is associated with an increased risk of OSA?
3 and 4
What is the gold standard to confirm the diagnosis of OSA?
Polysomnography
