Investigation and Treatment of OSA and Respiratory Failure Flashcards
Define apnoea.
Stop breathing for 10s
Define Obstructive Sleep Apnoea.
Stopping (or slowing) of breathing during sleep due to the obstruction (narrowing) of the upper airway
Define Hypopnoea.
Reduced airflow for 10s
Why do people with OSA have daytime consequences of excessive sleepiness?
Stop breathing → O2 decrease → brain makes you gasp
Recurrent brief arousal to clear airway
Name some risk factors for OSA (4 main)
Obesity
Lower facial shape
Nasal problems
Alcohol/sedatives
Menopause, NMJ diseases/stroke, Tonsils, Hypothyroid, Smoking, Acromegaly
What are the daytime and nocturnal presenting features of OSA?
Day: Sleepiness, morning headaches, dry throat, poor concentration/irritability, anxiety/depression, loss of libido
Night: Snoring, choking, apnoeas, sweats, restless sleep, vivid dreams, nocturia
Why is nocturia a feature of OSA?
Take deep breath → negative pleural pressure → RV flow → RA dilation → ANP → urination
What does oximetry measure? and what level is indicative of OSA?
O2 saturations, in OSA it gets to 40-50%
What do the sleep study tests record?
- Pulse
- Audio
- Sleep position
- Oxygen saturations
- Nasal flow
- Movement
“Points Are SO Non Memorable”
Also chest movements and video
What does polysomnography involve?
Measuring sleep stages EEG, eye movements, skeletal muscle movements, respiratory airflow, respiratory effort and pulse oximetry
How do you manage OSAHS?
Lifestyle changes
Bariatric Surgery
CPAP (gold standard) - Mild to severe
No alcohol before sleep
What are the symptoms of respiratory failure - hypoventilation?
Sleepiness
Headaches
Ankle Swelling
How would you treat respiratory failure - hypoventilation?
Non-invasive ventilaition: CPAP, BiPAP
