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Respiratory System > Respiratory Sleep Disorders > Flashcards

Respiratory Sleep Disorders Flashcards

1
Q

what is obstructive sleep apnoea (OSA)?

A

cessation of breathing at night due to respiratory tract closing periodically

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2
Q

what can cause obstructive sleep apnoea?

A

obesity
neuromuscular disorders
narrow pharynx

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3
Q

what can be symptoms of OSA?

A

daytime sleepiness
unrefreshing sleep
poor concentration
snoring

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4
Q

how can OSA present at night time, depending on the level of obstruction?

A

snoring if not completely obstructed

O2 desaturation if complete obstruction

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5
Q

what are the reasons for unrefreshing sleep and daytime somnolence in OSA patients?

A

microarousals of the brain to encourage breathing

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6
Q

what investigations can be done to diagnose OSA?

A

history/examination
Epworth Sleepiness scale
Overnight sleep study

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7
Q

what kinds of overnight sleep tests can be done for OSA diagnosis?

A

pulse oximetry
limited sleep studies
polysomnography (PSG)

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8
Q

what treatments are available for OSA?

A

manage underlying cause (eg obesity)
CPAP
mandibular splint

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9
Q

how common is obstructive sleep apnoea?

A

2% of men, 1% of women are affected

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10
Q

what characterises narcolepsy?

A

cataplexy
hypnagogic hallucinations
sleep paralysis
excessive daytime somnolence

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11
Q

what advice should be given to OSA patients?

A

OSA patients shouldn’t drive until the problem has been treated. DVLA should be notified of moderate/severe OSA

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12
Q

what are normal/abnormal levels of nighttime O2 desaturation levels?

A

0-5 normal
5-15 mild
15-30 moderate
30> severe

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13
Q

what is the prevalence and aetiology of narcolepsy?

A

0.05% of population affected
familial condition
associated with a certain haplotype

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14
Q

what are the treatments for narcolepsy?

A

sodium oxybate
clomipramine
modafinil

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15
Q

what characterises chronic respiratory failure?

A

high pCO2
low PO2
high bicarbonate
normal plasma pH

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16
Q

what disorder should be considered in patients with chronic respiratory failure, if they are not obese or smokers?

A

neuromuscular disorders causing hypoventilation

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17
Q

what tests should be done to diagnose neuromuscular disorders causing chronic respiratory failure?

A

lung function tests (sitting and standing)

assessing hypoventilation severity (oximetry, PSG)

18
Q

how can chronic respiratory failure caused by neuromuscular disorders be managed?

A

NIV at home (BiPAP)
Oxygen therapy
t-IPPV

19
Q

what is a normal sleep pattern in newborns?

A

16-18 hours sleep, wake up every 4 hours

no day/night sleep pattern

20
Q

what is a normal sleeping pattern in foetuses in utero?

A

increasingly regular periodic breathing

onset of REM sleep

21
Q

what is a normal sleeping pattern in 6 month old infants?

A

14-15 hour sleep, longer at night

1-2 naps during the day

22
Q

what is a normal sleeping pattern in 2 year old toddlers?

A

12 hour at night

1 daytime nap

23
Q

at what age is a child’s sleep the most efficient?

A

prior to adolescence

24
Q

what characterises teenage sleep patterns?

A

frequent awakenings, need more sleep than they get

25
Q

what are some common causes of sleeplessness in children?

A
  • behavioural, parents’ response has an impact
  • neurological disorders
  • effect of medicines
26
Q

what are some common causes of excessive somnolence in children?

A
  • insufficient sleep
  • narcolepsy
  • obstructive sleep apnoea
27
Q

what are some main differences in obstructive sleep apnoea between children and adults?

A
  • cause: swollen tonsils/adenoids (children) vs obesity (adults)
  • presentation: hypoventilation (children) vs apnoea (adults)
  • no daytime sleepiness (children) vs daytime sleepiness (adults)
  • breathing with mouth open (children), not adults
28
Q

what is a useful investigation to assess sleep disturbances in children?

A

polysomnography is Gold standard

29
Q

what are some neurological disorders which can cause sleep disturbances in children?

A
  • Duchenne’s muscular dystrophy
  • Down’s Syndrome
  • Cerebral Palsy
  • Prader-Willi Syndrome
30
Q

what are some respiratory disorders which can cause sleep disturbances in children?

A
  • chronic neonatal lung disease
  • cystic fibrosis
  • asthma
31
Q

what is the treatment of OSA in children?

A

remove smoke from environment
CPAP if needed
adenotonsillectomy
weight loss

32
Q

what is the prevalence of OSA in children?

A

2% of kids (1:1 girls and boys)

33
Q

what are some complications of OSA in children?

A
  • failure to thrive
  • cognitive deficits (ADHD)
  • may develop hypertension/cor pulmonale
34
Q

what neurological condition is more likely to present with OSA at night?

A

Down’s syndrome

35
Q

What neurological conditions are likely to present with what sleep disturbance? disturbed sleep pattern or excessive daytime somnolence?

A

cerebral palsy - disrupted sleep
prader-willi syndrome - increased daytime sleepiness
down’s syndrome - OSA
Duchenne’s muscular dystrophy - respiratory failure

36
Q

what type of management has significantly increased the QoL of children with Duchenne’s Muscular dystrophy with regards to sleep patterns?

A

BiPAP machines

37
Q

what is the definition of primary snoring in children?

A

snoring without any other symptoms (eg hypoxia, hypercapnia, apnoea)

38
Q

what is a potential complication of snoring in children?

A

it may progress to OSA

it may require adenotonsillectomy

39
Q

what can be a sleep related symptom of chronic neonatal lung disease, and what is it similar to?

A

hypoxaemia during REM sleep

similar thing happens in COPD

40
Q

what is the average percentage of children who present with primary snoring?

A

about 10%

Respiratory System (7 decks)

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