Sleep Apnea Flashcards
the more common Disorder, causes daytime sleepiness, impairs daily function, and is amajor contributor to cardiovascular disease in adults and to behavioralproblems in children.
OSAHS
Diagnosis requires the patient to have (1) either symptoms of nocturnal breathing disturbances (snoring, snorting, gasping, or breathing pauses during sleep)or daytime sleepiness or fatigue that occurs despite sufficient opportunities to sleep and is unexplained by other medical problems; and(2) five or more episodes of obstructive apnea or hypopnea per hourof sleep
OSAHS
calculated as the number of episodes divided by the number of hours of sleep
episodes of obstructive apnea or hypopnea per hour of sleep
the apnea-hypopnea index [AHI]
OSAHS also may be diagnosed in the absence of symptoms if the AHI is
> 15 episodes/h
Each episode of apnea or hypopnea represents a reduction in breathing for at least 10 s and commonly results in a how many % drop in oxygen saturation and/or a brain cortical arousal
≥3%
OSAHS maybe most severe duringthis stage of sleep (rapid eye movement) sleep, when neuromuscular output to the skeletal muscles is particularly low, and in the supine position due to gravitational forces
REM
The airway may collapse at different sites, such as the
soft palate (most common),
tongue base
lateral pharyngeal walls
epiglottis
airway patency is dependent on the stabilizing influence of the
pharyngeal dilator muscles.
True or false:
increasing levels of CO2 during sleep result in central nervous system arousal, causing The individual to move from a deeper to a lighter level of sleep or-to awaken
True
Two major risk factors of OSAHS
Obesity
MALE SEX
What risk factor cause >/=4x risk for OSAHS with 10% weight gain causing more than 30% increase in AHI
obesity
True or false
There is an INCREASED OSAHS prevalence in women after MENOPAUSE
True
Genetic predisposition in OSAHS is _x in first degree relatives
2x increased
What is the most common complaint is OSAHS
SNORING
What DISTINGUISHES OSAHS from paroxysmal nocturnal dyspnea , nocturnal asthma and GERD
DYSPNEA
Most common daytime symptoms in OSAHS
Excessive sleepiness
What is the GOLD STANDARD for diagnosis of OSAHS
Overnight POLYSOMNOGRAM PSG
is the standard medical therapy with the highest levelof evidence for efficacy.
CPAP
(removal of the uvula and the margin of the soft palate) is the mostcommon surgery and, although results vary greatly, is generallyless successful than treatment with oral appliances.
Uvulopalatopharyngoplasty
is often caused by an increased sensitivityto pCO2, which leads to an unstable breathing pattern that manifests as hyperventilation alternating with apnea
CSA central sleep apnea
individuals with congestive heart failure are at risk for CSA. With prolonged circulation delay, there is a crescendo-decrescendo breathing pattern known as
Cheyne-Stokes respiration
Cessation of airflow for >or=10seconds during sleep
Apnea
Cessation of airflow for >or=10seconds during sleep accompanied by persistent respiratory effort
Obstructive apneas
Cessation of airflow for >or=10seconds during sleep accompanied by absence of respiratory effort
Central apneas
More than or equal 30% reduction in airflow for at least 10 secs during sleep that is accompanied by either >/= 3% desaturation or an arousal
Hypopnea
A partially obstructed breath that does not meet the criteria for hypopnea but provides evidence of increasing inspiratory effort (usually thru pleural pressure monitoring) punctuated by arousal
RERA Respiratory effort related arousal
Partially obstructed breath , typically within a hypopnea or RERA, identified by a flattened or “scooped out” inspiratory flow shape
Flow limited breath
