Obstructive sleep apnea Flashcards
Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is a common sleep disorder characterised by recurrent episodes of partial or complete upper airway obstruction during sleep, leading to intermittent hypoxia and arousals from sleep. What is the duration that typically defines apnea?
1 - >5 seconds
2 - >10 seconds
3 - >15 seconds
4 - >20 seconds
2 - >10 seconds
Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is a common sleep disorder characterized by recurrent episodes of partial or complete upper airway obstruction during sleep, leading to intermittent hypoxia and arousals from sleep. What is the incidence of this?
1 - 12,500 cases per 100,000
2 - 1250 cases per 100,000
3 - 125 cases per 100,000
4 - 12 cases per 100,000
3 - 125 cases per 100,000
At what age does the incidence of Is Obstructive sleep apnoea typically peak?
1 - 60-70
2 - 50-60
3 - 40-50
4 - 30-40
2 - 50-60
Is Obstructive sleep apnoea more common in men or women?
- men
- 2:1 ratio
Organise how airs enters the lungs?
1 - laryngopharynx
2 - nasopharynx
3 - trachea
2 - nasopharynx
1 - laryngopharynx
3 - trachea
Which of the following does NOT typically increases the risk of obstructive sleep apnoea?
1 - obesity
2 - macroglossia (enlarged tongue)
3 - acromegaly (abnormal growth of hands etc, normally growth hormone)
4 - hypothyroidism
5 - amyloidosis
6 - female gender
7 - large tonsils
8 - Marfan’s syndrome
9 - nasal septum defects/polyps
6 - female gender
More likely in men
In children, which of the following is the most common cause of obstructive sleep apnoea?
1 - enlarged tonsils ± adenoids
2 - increased BMI
3 - syndromes
4 - central neurological
1 - enlarged tonsils ± adenoids
How can obesity increase the risk of obstructive sleep apnoea?
1 - fat infiltrates enter the lungs
2 - fat deposits build up around glottis
3 - weight of fat narrows airways
4 - all of the above
3 - weight of fat narrows airways
Why does marfans increase the risk of obstructive sleep apnoea?
1 - tall features stretches airways and makes narrower
2 - connective tissue more likely to collapse
3 - weight of fat narrows airways
4 - all of the above
2 - connective tissue more likely to collapse
Why does hypothyroidism increase the risk of obstructive sleep apnoea?
1 - tall features stretches airways and makes narrower
2 - connective tissue more likely to collapse
3 - weight of fat narrows airways
4 - thyroid is typically hypertrophied and narrows airways
4 - thyroid is typically hypertrophied and narrows airways
How can amyloidosis increase the risk of obstructive sleep apnoea?
1 - amyloid deposition in airway
2 - connective tissue more likely to collapse
3 - weight of fat narrows airways
4 - thyroid is typically hypertrophied and narrows airways
1 - amyloid deposition in airway
Amyloid deposition in the tongue, submandibular and sublingual glands as well as soft tissues around the neck
How can acromegaly increase the risk of obstructive sleep apnoea?
1 - amyloid deposition in airway
2 - enlarged neck circumference
3 - weight of fat narrows airways
4 - thyroid is typically hypertrophied and narrows airways
2 - enlarged neck circumference
What is the key feature of why apnea is worse at night?
1 - airways contract and become narrows during night
2 - increased cortisol causing vasodilation of airways
3 - hormones induce muscular relaxation
4 - all of the above
3 - hormones induce muscular relaxation
Do patients with obstructive sleep apnoea get a good quality of sleep?
- no
Typically woken by apnea and somnolence (drowsiness or strong desire to fall asleep)
Which of the following can obstructive sleep apnoea lead to?
1 - metabolic acidosis
2 - metabolic alkalosis
3 - respiratory acidosis
4 - respiratory alkalosis
3 - respiratory acidosis
Typically this is compensated as interruptions in breathing lead to CO2 retention
The risk of all of the following can be increased by obstructive sleep apnoea, EXCEPT which one?
1 - stroke
2 - COPD
3 - hypertension
4 - myocardial infarction
2 - COPD
Children can also experience development issues
Which of the following is NOT a common symptom of obstructive sleep apnoea?
1 - snoring
2 - antonyms
3 - episodes of apnea during sleep
4 - fatigue
5 - headaches
2 - antonyms
- this means energetic and awake
Patients typically have somnolence, a state of sleepiness and fatigue
Which questionnaire can be used to assess the degree of sleep deprivation in a patient?
1 - Wells score
2 - Epworth Sleepiness Scale
3 - CURB-65
4 - Centor score
2 - Epworth Sleepiness Scale
A score greater than what in the Epworth Sleepiness Scale would indicate obstructive sleep apnoea and then require a sleep study?
1 - >2
2 - >7
3 - >11
4 - >15
3 - >11
How is the diagnosis of sleep apnea typically made?
1 - endoscopy during sleep
2 - collateral history
3 - sleep study
4 - clinical diagnosis
3 - sleep study
Includes:
- pulse oximetry
- polysomnography (EEG, respiratory airflow, thoraco abdominal movement, snoring and pulse oximetry
More episodes of sleep apnea = more severe form of sleep apnea
In children, is a sleep study always performed in children with suspected obstructive sleep apnoea?
- no
May do pulse oximetry overnight.
Multiple desaturations is suggestive of obstructive sleep apnoea
Which of the following is NOT a treatment for obstructive sleep apnoea?
1 - weight loss/reduce alcohol
2 - continuous positive airway pressure (CPAP)
3 - intra-oral devices (e.g. mandibular advancement)
4 - medications
5 - DVLA notified if excessive daytime sleepiness
4 - medications
No strong evidence to support the use of medications
In children what is a treatment offered that would not typically be offered to adults?
1 - weight loss
2 - continuous positive airway pressure (CPAP)
3 - intra-oral devices (e.g. mandibular advancement)
4 - tonsillectomy ± adenoidectomy
4 - tonsillectomy ± adenoidectomy
Main cause in children
Which of the following is the LEAST likely cause of central sleep apnea?
1 - obesity
2 - stroke
3 - opioids
4 - heart failure
1 - obesity
More likely to cause obstructive sleep apnea
Brain doesn’t tell us to breath properly, and heart failure is the most common cause
