OSA

Question 1

OSA one liner

Answer 1

a sleep disorder characterized by an obstructive apneas and hypopneas because of upper airway collapse.

Question 2

questionnaires for OSA

Answer 2

OSA questionnaires
STOPBANG - snoring, tired, some observed stop breathing, high blood pressure, BMI, age over 50, neck circumference greater than 16 inches, Male Gender
Epiworth sleepiness scale - dozing off while doing progressively more engaged activities - reading, watching tv, passenger in a car, while driving.

Question 3

what medical conditions are associated with OSA

Answer 3

Pulmonary hypertension, hyertension, arrhythmias, CHF (right), MI, stroke, seizure, diabetes, decreased cognitive function, Depression, acid reflux, secondary polycythemia
(memorize 4)

Question 4

level of obesity and neck circumference associated with OSA

Answer 4

BMI greater than 30 kg
neck circumference greater than 17 males, 16 females.
(carls neck is 17 inches)

Question 5

what is the Fujita classification as it pertains to OSA

Answer 5

Level of obstruction is the fujita classification
Type 1 - Palate is the level of the obstruction
type 2 - is the palate and the tongue
type 3 - is the base of tongue obstruction

use to guide what surgery to do?

Question 6

How do you diagnose OSA?
gold standard and other diagnostics

Answer 6

Polysomnogram is the gold standard

other is nasophargoscopy with Mueller’s maneuver ( inhalation with nasal passages occluded)
drug induced sleep endoscopy
home sleep test

Question 7

define apnea and hypopnea

Answer 7

apnea is a cessation of airflow for at least 10 seconds
hypopnea is a reduction of airflow resulting in arousal - there is more specifics to this but not worth memorizing

Question 8

what are the levels of sleep apnea

Answer 8

Base on AHI
0-4 is normal
5-15 is mild OSA
16-30 moderate OSA
greater than 30 is sever OSA

Question 9

What is the RDI? how does it differ from AHI

Answer 9

RDI is the respiratory disturbance index and includes apnea and hypopneas AND respiratory event related arousal which is not included in AHI

Question 10

what are some measurements on lateral ceph as they relate to Sleep apnea?

Answer 10

Posterior airway space (less than 11 is correlated to OSA) - indicates a base of tongue obstruction
P to PNS - measures the soft palate normal is (normal is 33-40) longer associated with OSA
H to MP - perpendicular to the mandibular plane line drawn to hyoid bone . longer than 15 mm is associated with OSA and UPPP failure

Question 11

non surgical therapy for OSA

Answer 11

CPAP
dental appliance (mild to moderate OSA or in combination with CPAP)