OSA Flashcards
What are the 4 history clues for OSA?
Impaired daytime attention for no reason
Snoring
Witnessed Apnea
Mood alterations
What patient population should always be screened for OSA?
Obese patients with depression
What are 6 characteristics of the typical OSA patient?
Obese Large neck Nasal obstruction Enlarged tonsils Narrow oropharynx Small jaw
2 main goals we have for managing OSA patients?
Improve daytime sleepiness and prevent long term complications
What are the 3 long term complications resulting from OSA?
More likely to die
More likely to develop cancer
More likely to have a CVA
What are 4 lifestyle modifications for OSA?
Lose weight
Avoid alcohol and sedatives a few hours before sleep
Lateral decubitus sleeping position
Intranasal decongestants can help
What are the two effects CPAP has on the patient?
Increased intraluminal airway pressure and FRC
What are two other tools we can use for the patient besides CPAP?
Mandibular assist device and UPPP
How does the mandibular assist device work?
It protrudes the jaw and pulls the tongue forward, opening the airway up
What is going on during a UPPP procedure?
They respect part of the oropharynx so the airway is larger
What are the 3 main systems being affected by Obesity Hypoventilation Syndrome?
Respiratory, which includes the airway, CNS, and CV
What is the problem with the CNS?
Decreased central respiratory drive
What is going on with the airway?
OSA
What two things are going on with the heart?
CAD and CHF
What is going on with the lungs? 4 things
Restrictive chest physiology
PHTN
Hypoxemia and Hypercapnia
Chronic respiratory acidosis with attempted compensation
What condition can OHS mimic, but what does the PFT look like?
Mimic COPD, but PFT is restrictive
90% of OHS patients have what condition?
OSA
OSA with marked hypoxemia can lead to secondary what?
Erythrocytosis
What is the most common manifestation of OSA?
Excessive daytime sleepiness
What are two tools we can use to screen for OSA?
Epworth sleepiness scale and stop bang questionnaire
What is the most important risk factor for OSA?
Obesity
What kind of women are at risk for OSA?
Postmenopausal
What study is needed to diagnose OSA and what is the confirming test result?
PSG.
Apnea-hypo apnea index greater than 5 confirms OSA.
What are the two big time sequelae of untreated OSA?
Heart failure and stroke
What are the two cornerstones of therapy for OSA?
Lifestyle changes and CPAP
What can we put patients on if CPAP is not comfortable for them?
BIPAP
