Oral Cavity/Sleep

Question 1

Define Obstructive Sleep Apnea and the ASM classification

Answer 1

5 respiratory events (Apnea, hypopnea, RERAs) per hour of sleep + symptoms and co morbids OR
15 events without Sx or co morbids

Mild: 5-15
Moderate: 15-30
Severe:>30

Question 2

Define Apnea

Answer 2

Complete cessation of airflow for 10s

Question 3

Define hypopnea

Answer 3

Reduction in airflow
A. 30% reduction of airflow, 4% 02 reduction
B. 50% reduction of airflow,3% 02 reduction
C. Arousal on EEG

Question 4

Define Respiratory effort related arousal

Answer 4

Sequence of breath lasting 10s leading to increased respiratory effort then arousal
Flattening of nasal waveform
Does not meet Apnea/hypopnea

Question 5

Obstructive Apnea

Answer 5

Thoracoabdominal effort associated with cessation of airflow

Question 6

Central Apnea

Answer 6

Lack of thoracoabdominal effort during cessation of airflow

Question 7

Mixed Apnea

Answer 7

Starts as central then becomes obstructive

Question 8

Four key abnormalities contributing to OSA

Answer 8

1. Impaired upper airway anatomy -narrow, collapsible
2. Low respiratory arousal threshold
3. Ineffective pharyngeal dilators
4. Unstable ventilatory control

Question 9

3 major areas of obstruction in OSA

Answer 9

Nose, palate, hypopharynx

Question 10

Define tracheal tug

Answer 10

The mechanical traction by lung and thorax leading to pharyngeal collapse due to decreased lung volume in obese patients

Question 11

Most important muscle in maintaining airway patency in OSA

Answer 11

GENIOGLOSSUS