February 16, 2016 - SG18 - Daytime Sleepiness Flashcards
Predictive Features of OSA
Neck circumference
BMI
Snoring
Nocturnal choking or gasping
Hypertension
DDx for Sleepiness
Inadequate total sleep time
Poor quality of sleep
Medical or psychiatric causes
Intrinsic sleep disorders
Limitations of Level 3 Testing
Does not diagnose any other disorder other than OSA.
You need polysomnography for other conditions.
Treatment for OSA
CPAP
Oral appliance
UPPP (surgery)
Chest Paradox in OSA
When the airway is occluded, when the diaphragm engages it will drop the intrathoracic pressure which results in the sucking in of the chest wall on inspiration, rather than the normal expansion.
Aa Gradient
Aa Gradient = 130 - (CO2 / 0.8) - PaO2
BiPAP
Bilevel positive airway pressure.
Uses a time-cycled change between two different levels of positive airway pressure to basically breathe for you. Can lead to atrophy of the diaphragm and you may want to switch over to CPAP at a later time.