Lectures Flashcards
What is sleep apnoea?
When a person stops breathing for up to 10 seconds while sleeping.
What is narcolepsy?
sleep disorder which affects the brains’ ability to regulate the normal sleep-wake cycle. This can lead to symptoms such as disturbed night-time sleep and excessive sleepiness throughout the day.
What is cataplexy?
Cataplexy- lose muscle tone and collapse, usually during emotional states
What are the symptoms of sleep apnoea?
¥ Daytime somnolence /sleepiness
¥ Poor daytime concentration
¥ Waking up during the night
The patient tends to wake up frequently during the night due to not being able to breath which results in an unrefreshing sleep.
State three reasons why sleep apnoea may occur
¥ Muscle relaxation
¥ Narrowing of the pharynx
¥ Obesity
State some life style consequences which could occur with sleep apnoea.
¥ Impaired quality of life – constantly feeling tired
¥ Marital disharmony
¥ Increased risk of RTA’s
¥ Associated with hypertension, increased risk of stroke and probably increased risk of heart disease.
State some common consequences of sleep apnoea for children.
o failure to thrive
o neurocognitive defects/adhd
o systemic hypertension
o cor pulmonale
What treatment can be done to help with sleep apnoea?
Simple life style changes such as; alcohol, exercise, diet, weight reduction
Continuous positive airways pressure (CPAP)
Adenotonsillectomy
Mandibular repositioning splint
Name five tests that can be done to help confirm the diagnosis of sleep apnoea.
¥ Clinical history and examination ¥ Epworth Questionnaire – filled in by patient and partner independently. 11/24 usually indicates apnoea. ¥ Time lapse video ¥ Oxygen/CO2 monitoring ¥ Overnight sleep study
what is the prevalence of sleep apnoea in the public?
2% of men and 1% of women
state the symptoms of narcolespy.
¥ Cataplexy- lose muscle tone and collapse, usually during emotional states
¥ Excessive daytime somnolence
¥ Hypnagogic hallucinations
¥ Sleep paralysis
Does narcolepsy tend to run in families?
yes
What drugs can be used to treat narcolepsy
¥ Modafinil
¥ Clomipramine (for cataplexy)
¥ Sodium Oxybate (Xyrem)
Chronic ventilatory failure: what are the levels of PO2 and PCO2 like in the blood?
¥ Elevated pCO2 (> 6.0 kPA)
¥ pO2
Can you state the symptoms associated with chronic ventilation failure
- Breathlessness
- Orthopnoea- SOB lying flat
- Ankle swelling
- Morning headache- retension of CO2 during the night
- Recurrent chest infections
- Disturbed sleep
What are some of the causes of chronic ventilation failure?
- Airways disease
- COPD
- bronchiectasis
- OSA - obstructive sleep apnoea
- Chest wall abnormalities
- Kyphoscoliosis
- Respiratory muscle weakness
- motor neurone disease (ALS)
- muscular dystrophy
- Central hypoventilation
- obesity hypoventilation syndrome
- central hypoventilation syndrome (Ondine’s curse)
State an examination finding with the condition chronic ventilatory failure.
paradoxical abdominal wall motion - diaphragm is weak and cannot relax properly so there is a dip in the abdomen. Ankle oedema (hypoxic cor pulmonale) Lying and standing vital capacity
With chronic ventilatory failure, will the spirometry show obstructive or restrictive patterns?
restrictive
What is the treatment for chronic ventilatory failure?
♣ Domicillary Non Invasive Ventilation (NIV)
♣ Oxygen therapy
State three normal sleeping phenomena
o Sleep walking - middle childhood
o Sleep terrors - “look of fear”
o Hypnic jerks
what is primary snoring ?
Snoring without apnea (stop breathing), hypoventilation, hypoxia, hypercarbia, daytime symptoms
what is the prevalence of primary snoring?
~10%
Name some Neurological conditions associated with respiratory muscle weakness.
Cerebral palsy
- fragmented sleep/delayed onset
- Treatment - melatonin
Down syndrome
- OSAS
Prader-Willi syndrome
- excessive daytime sleepiness
Neuromuscular disease (Duchenne’s MD)
