Obstructive Sleep Apnea Flashcards
OSA
What is the definition of apnea and hypoapnea?
apnea: not breathing for >10 seconds
hypopnoea: reduced breathing
OSA
What causes the apnea?
a repetitive complete or partial collapse of the upper airway during sleep
OSA
What anatomical parts of the body can cause obstruction of the upper airway?
3
- base of the tongue
- soft palate with uvula
- epiglottis
OSA
How long can apneaic episodes last for and how many times per night?
- 20 seconds to 3 minutes
- 100-160 episodes per night
OSA
What are the nighttime and daytime symptoms?
night:
snoring
snorting
choking
awakening in the night
day:
morning headache
sleepiness
OSA
What scoring system do we use to assess sleepiness?
How is it scored?
What can it help us distinguish sleepiness from?
The Epworth Sleepiness Scale (ESS) (score of 10 or more) can be used to distinguish sleepiness from fatigue.
OSA
In the long run, patients with untreated OSA are at increased risk of ____, ____, ____ and ____.
hypertension
CAD
CVA
arrythmias
OSA
Chronic hypoxaemia can have long term effects on the body. Name 3.
pulmonary hypertension, right ventricular dysfunction and cor pulmonale
cor pulmonale: abnormal enlargement of the right side of the heart as a result of disease of the lungs or the pulmonary blood vessels
OSA
Name some risk factors.
7
- obesity
- older age
- male sex
- Craniofacial and upper airway abnormalities
- mechanical obstruction (neuromuscular diseases)
- family history
- smoking
OSA
Diagnosis is based on clinical symptoms and the frequency of respiratory events during sleep, as measured by ____.
nocturnal polysomnography
OSA
In asymptomatic pts how many apneic events need to occur per hour to get a diagnosis? What about in symptomatic pts?
asymptomatic: 15+
symptomatic: 5+
OSA
What questionnaire can we use for a preoperative evaluation of patients with undiagnosed OSA?
STOP-Bang
OSA
What is the STOP-Bang questionnaire?
How is it scored?
The STOP-Bang questionnaire is an eight-item survey that incorporates information on:
Snoring
Tiredness
Observed apneas
Blood pressure
Body mass index (BMI)
Age
Neck circumference
Gender
A score of 3 or higher suggests the diagnosis of OSA.
OSA
Differential diagnoses for OSA are based on the presenting complaint. These can range from reasons such as ________
Distinctions are made via clinical history and polysomnography.
name a few
insufficient sleep, sleep disorders, neurologic disorders, psychiatric disorders to medications.
OSA
How do we confirm diagnosis?
Nocturnal polysomnography (PSG)
