Obstructive Sleep Apnoea Flashcards
What is sleep apnea
There are 2 types of SA
Right-Obstructive sleep apnoea
Left-Central sleep apnoea
Making respiratory effort and no airflow then airway must be blocked off =OBSTRUCTIVE sleep apnoea
Sleep influences chemosensitivity, reps muscle activity and output and input to respiratory centres. So sleep has a big impact on breathing.
Obstructive sleep apnoea
What happens if you don’t breathe at night?
Extra pressure due to obesity
Compliant airway as when they sleep get reduced muscle tone
Reduced tone of tongue so tongue can fall back and block airway.
Negative Intraluminal pressure as you breathe in
Apnea-cessation of breathing, it is intermittent as its not a prolonged low oxygen that you’d get in a patient with chronic lung disease.
Wake up-fragmented sleep pattern-reduced cognitive function and sleepiness.
What is sleep?
Its the deep sleep that is restorative and makes you feel better.
Sleep loss in OSA:
Patient falls asleep quickly but haven’t had any deep restorative sleep so will feel like their sleep is fragmented.
Subjective measurement of sleepiness:
Anything over 10 or 11, need to think about.
Take epworth sleepiness scale, ask if they snore, and ask patient to open mouth to view anything obvious in upper airway which could block off airway
Once done diagnostic test eg epworth sleepiness scale etc.
Decide whether to treat them and how?
How do you define severity of sleep apnoea?-have to measure sleep breathing overnight. So difficulty in diagnosing is the fact you have to monitor them asleep.
Diagnosis of Obstructive sleep apnea
Over 30 events is severe OSA-getting surges in sympathetic activity and hypoxia so this is a cardiac risk
2 bands around the chest to monitor respiratory effort and cannula on nose to monitor breathing
Pink boxes show where patient is not breathing and each pink box represents a dip in oxygen
Use a hypopnea, apnoea trace to diagnose this
Brompton treatment algorithm for SDB
CPAP treatment
Not all patients can tolerate wearing a mask at night.
Work by blowing air into patients airway
Adherence to CPAP therapy:
Each green bar is a day-there are 30 days and red lines are less than 4 hours a night so not beneficial.
Important to give patients support for CPAP use. Apps, engagement, goal setting.
Get them to use it asap. Worrying as sleepiness can lead to accidents.
Alternative treatment for sleep apnoea
Each green bar is a day-there are 30 days and red lines are less than 4 hours a night so not beneficial.
Important to give patients support for CPAP use. Apps, engagement, goal setting.
Get them to use it asap. Worrying as sleepiness can lead to accidents.
Positional sleep apnoea
On back-tongue is more likely to fall back
On this panel, yellow boxes show when they lie on their back and these link to dips in oxygen.
Positional therapy:
Key points for sleep apnoea
