Lecture 17 - Sleep Disorders

Question 1

Obstructive Sleep Apnea (OSA) is defined as greater than or equal to _____ obstructed breathing events per hour of sleep.

Obstructive apnea = breathing pause despite respiratory effort lasting greater than or equal to ____s.

Hypopnea is defined as greater than or equal to ___s of continued breathing with REDUCED AIR FLOW associated with cortical arousal (coming out of sleep essentially) or oxyhemoglobin desaturation of ___-___%.

Answer 1

5

10s

10s

3-4%

Question 2

Apnea Hypopnea Index (AHI) cutoffs:

Mild –> AHI __-__

Moderate –> AHI __-__

Severe –> AHI > ___

Answer 2

5-15

15-30

> 30

Question 3

________ is the gold standard for sleep apnea diagnosis.

Home sleep apnea testing is less _____, so a negative result would require further testing.

Answer 3

Polysomnography

Sensitive

Question 4

OSA decreases _____ sensitivity and increases _____ resistance. It should make sense then that patients are at higher risk for developing Diabetes.

Answer 4

Isulin

Leptin

Question 5

Negative pressure in the upper airway induces the __________ muscle to fire APs in an attempt to move the tongue forward/open the airway.

Answer 5

Genioglossus muscle

Question 6

How does severity of OSA correlate with Loop Gain (disproportionately large response to apnea)?

Answer 6

As OSA severity increases, so too does Loop Gain.

Question 7

Eszopiclone mediates the _____ threshold (patients become aroused at lower Critical Pressures to allow for resumption of breathing) in OSA patients and was shown to decrease AHI in these patients significantly.

Answer 7

Arousal threshold

Question 8

Stop Bang has a high sensitivity for _____ and _____ OSA.

Answer 8

Moderate and Severe

Question 9

Narcolepsy is caused by a loss of _______ neurons.

Answer 9

Hypocretin neurons

Question 10

Patients with Narcolepsy may describe experiencing sleep paralysis, hypnagogic or hypnopompic ______, and _______. The last one occurs in Type 1 Narcolepsy ONLY.

Answer 10

Hallucinations

Cataplexy

Question 11

Greater than or equal to 2 episodes of early ______ during Multiple sleep latency test (5 naps, 2 hours apart), is diagnostic of Narcolepsy.

Answer 11

REM

Question 12

_____ _____ (date rape drug) can be used to treat Narcolepsy, and it specifically helps decrease episodes of ______.

Answer 12

Sodium Oxybate

Cataplexy

Question 13

REM behavior disorder has a VERY high association with _______ disorders later in life.

Answer 13

Neurodegenerative disorders.