Sleep Apnea Flashcards
1
Q
What causes snoring
A
Increased Resistance Deviated septum Rhinitis Upper resp infection Enlarged or relaxed spft palate/uvula
2
Q
Symptoms of Sleep Apnea
A
Witnessed pause in breathing Waking gasping for air Morning HA Daytime sleepiness Frequent nighttime urination Personality changes - irritability, poor behavior in kids, more aggressive
3
Q
Risk Factors
A
Male Post-menopausal female Pregnancy Obesity Large girth neck Small mandible (ex. Down syndrome) Lung dz, Heart dz, DM, neuromusc. dz
4
Q
Dx
A
Sleep study (Polysonography)
Record sleep during habitual sleep time
Monitor EEG, EKG, breathing, pulse ox, leg movements, usually video taped
If certain indicators are met - “split study” = 1/2 night w/o CPAP, 1/2 night c CPAP
5
Q
Categories of Apnea
A
Hypopnea = shallow breathing
Apnea = no air movement
Obstructive apnea
Central apnea - Chenne Stokes
6
Q
Classification
A
Normal = Up to 5 events/hr MIld = 5-15/hr Mod = 15-30/hr Severe = >30/hr
Also consider: O2 desat & daytime sleepiness
7
Q
Tx Snoring
A
Tx rhinitis Nose/throat surgery "Pillar" procedure Oral appliances - keeps mandible aligned Wt loss
8
Q
Tx OSA
A
Mild-mod: Clear rhinitis Wt loss Oral appliance ENT surgery Positional therapy - if appropriate - if pt only has apneic episodes in one position
Severe:
CPAP
Wt loss
ENT surgery and Oral appliances usually not as successful
9
Q
CPAP Rx
A
Write for "CPAP machine and supplies" Need mask, hoses, humidifier... Write for specific pressure Most insurance will pay CPAP company will come to house and help pt set up
10
Q
Factors that worsen snoring and OSA
A
Wt gain URI/Seasonal allergies - Rhinitis Sleep deprivation Meds Sedating meds Cold preparations ETOH *Anything that changes sleeping architechture*
11
Q
Consequences of untreated OSA
A
Daytime sleepiness
Unrefreshing sleep
HTN, heart dz, CVA
12
Q
Benefits of tx
A
Everyone sleeps better Better quality sleep Increased daytime alertness More energy Overall better health
