Obstructive Sleep Apnea Flashcards
Attempts to measure how deeply you are during the day
Epworth sleepiness Scale
Epworth sleppiness Scale Interpreatation
0-9 Normal
10-24 Excessive daytime Sleepiness
11-15 Mild to moderate sleep apnea
>16 Severe sleep apnea or narcolepsy
Additional question for OSA (Epworth Sleepiness Scale)
Do you snore or wake up unrefreshed?
Diabetic?
Hypertensive?
Intermittend obstruction of the Upper airway during sleep resulting in the total absence of flow (>10secons) despite contonued respiratory effort
OSA
NArrowest part of the pathway
oropharynx
Snoring
Soft palate vibrating
Main function of Sleep
Restore body function.
Only deep sleep has restorative effect
What triggers sleep?
Interplay between external and internal triggers
Sleep center
Suprachiasmatic nucleus in the midbrain
Average duration of Sleep
Children: 15 hours
Elderly : 3-4 hours
Average : 6-8 hours
Used to evaluate phases of sleep using pattern recognition to determine REM and NREM sleep
EEG
N1
Onset of sleep
Lightest Stage of Sleep
Easily aroused
Non-restorative
N2
Light/shallow sleep
Decrease in heart rate
Decrease in temperature
Non restorative
N3
Deep sleep/ Slow wave sleep
brain waves slow down
Difficult to wake up
If the patient does wake up from N3 (Disoriented)
REM
Very deep sleep Dreams Eyes are moving Dissociation with brain and muscle activity Phase where body is restored
EEG in REM
Similar to that of awake person
Sleep Cycle
Divided approximately every 90 minutes
1st cycle of Sleep cycle
lasts about 120 minutes
With each succeeding cycle,
NREM duration decreases while REM duration increases
Sleep becomes deeper as it ______
lengthens
Deepest sleep occur during??
Morning
total sleep time
Children: 9 hours/day, >500 min/day
Elderly: about 6-7 hours, about 360 min/day
SWS (slow wave sleep/ S3 and S4) is _________
greatly decreased as one ages
Most common dominant phase in sleep
S2
Time when you lie down to the time you go to sleep
Sleep latency
Pattern of sleep urge
bimodal pattern
Excessive daytime sleepiness
OSA syndrome
Cessation of breathing
OSA
Includes cardiovascular disease, diabets, OSA
Metabolic Syndrome
Type of malocclusion which refers to an abnormal posterior positioning of the maxilla or mandible, particularly the mandible, relative to the facial skeleton and soft tissues; a retrognathic mandible is coomonly referred to as overbite)
Retrognathia
Gold standard for diagnosing OSA
Polysomnograph
Polysomnograph
Measures number of hypopnea and obstructive apnea
Body wakes up if an obstruction occurs for >10 seconds
Apnea-Hypopnea Indes (AHI)
> 5 obstructions/hr = OSA
>30 obstructions in an hour = severe OSA
Done after definitive diagnosis
CPAP titration studies
CPAP
cure rate - 95-100%
Gold standard for treatment
Mechanical splint to open up the airway
