Sleep Apnea Flashcards
Infants need how much sleep?
16 hours
Teens need how much sleep?
9 hr
Adults need how much sleep?
7-8 hrs
Amount of sleep a night we got before the electric light bulb was invented.
10 hrs
Stage of sleep known as drowsiness, jerky movements.
Stage I sleep
This stage of sleep increases core and peripheral temperature, and relaxes muscles.
Autogenesis
Measures electrical activity at the surface of the brain.
Electroencephalogram (EEG)
The largest waves in an EEG.
Delta
Waves with the greatest frequency.
Beta
Sleep stage where there’s drowsiness and hypnic jerks.
Stage I
Waves in Stage I.
Alpha waves are replaced with Theta waves.
Stage I is what percent of Total Sleep Time?
5%
Need these for it to be Stage II sleep.
Spindles (assocaited with K complex).
Stage II sleep is what percent of total sleep time?
45
Stage II sleep does NOT have these characteristics:
- No eye movement
- Easily awake
- Dreaming is rare
How does the sleep spindle look?
Bunch of zig zags.
How does the K complex look?
Like a QRST complex in an EKG.
This stage is deep sleep or slow wave sleep.
Stage III
This sleep stage has Delta waves.
Stage III
This sleep stage has Delta waves more than 20% of the time.
Stage III
More common to find _________ in stage III of NREM sleep, though not as common as in REM sleep.
Dreaming
This most commonly occurs in Stage III sleep.
Parasomnia
What is parasomnia?
Weird things that people do in their sleep, like sleep walking.
This stage has Slow Wave Sleep (SWS)
III
When your muscles are in a paralyzed relaxed state.
Atonia
This sleep stage has:
- Rapid Eye movements
- Muscle atonia
- EEG desynchronization
REM
This sleep stage is AKA PARADOXICAL SLEEP because the brain activity is similar to that during waking hours.
REM
Considered the lightest stage of sleep, and normally occurs close to morning.
REM
A newborn baby spends more than 80% of total sleep time in this stage.
REM
NREM and REM cycles every….
90 minutes
In a sleep pattern, REM is at the ____ of the wave.
Top
In a sleep pattern, stage III is at the _____ of the wave.
Bottom
Not getting enough sleep makes you more sensitive to this.
Pain
These suppress slow wave sleep.
Marijuana and Benzos
This suppresses REM early in the night.
Pre-sleep alcohol
These suppress REM.
TCA’s and MAO Inhibitors
Disorder where there’s an extreme tendency to fall asleep, esp. in relaxing settings.
Narcolespy
The soft parts of the oropharyngeal walls vibrate during _____.
Snoring
Simple snoring is what?
When it doesn’t wake you up.
Higher pitched noise and frequency is what kind of snoring?
Pathological
Heavy snoring increases the risk of this.
Carotid atherosclerosis
UARS stands for.
Upper Airway Resistance Syndrome
Has crescendo snoring.
UARS
Associated with Respiratory Effort Related Arousals (RERA’s).
UARS
Normally, it takes how many times longer to breathe in than out?
3
In UARS, the time it takes to breathe in ____ the time it takes to breathe out.
equals
Type of apnea where there’s no airflow, even though you’re trying to breathe.
Obstructive apnea
Type of apnea where there’s no airflow bc there’s no breathing effort.
Central apnea
GERD is a sign of what?
Obstructive sleep apnea
Signs and Symptoms of Obstructive Sleep Apnea
- Snoring- intermittent with pauses
- excessive daytime sleepiness (EDS).
- Awakenings with gasping or choking
- Fragmented, non-refreshing, light sleep
- Poor memory, clouded intellect
- Irritability, personality changes
- Decreased sex drive, impotence
- Morning headaches
- GERD
Prevalence of OSA in men.
3-7%
Prevalence of OSA in women
2-5%
Prevalence of OSA in the US.
12 million
This increases your chances of getting a myocardial infarction.
OSA
When you stop breathing for at least 10 seconds.
Apnea
- At least 30% reduction in airflow
- Stop breathing for at least 10 seconds
- At least 4% reduction in blood oxygen.
Hypopnea
The number of apnea and hypopnea events per hour of sleep.
AHI Index
When you wake up bc your breathing is off.
RERA
Respiratory Effort Related Arousal
RDI stands for…
Respiratory Disturbance Index
RDI definition
Total number of apnea, hypopnea, and RERA’s per hour.
RDI is always higher than what?
AHI
Combination of central and obstructive apnea, with a central pattern evolving into an obstructive pattern.
Mixed Apnea
What do you want the minimum blood oxygen to be?
Above 90%
Sleep time where blood oxygen is below 90%.
T90
A recording of nocturnal sleep with duration of at least 6 hours, which is performed for diagnostic or treatment purposes.
Nocturnal PSG
Diagnostic study followed by application of a CPAP during the same night.
Split night PSG
CPAP stands for:
Continuous positive airway pressure
Where the patients report their sleepiness.
Epworth Sleepiness Scale (ESS)
STOP-BANG questionnaires for assessing obstructive sleep apnea had the highest methodological quality.
What does STOP-BANG stand for?
Snoring
Tiredness
Observed apnea
Pressure (BP)
BMI
Age
Neck circumference
Gender
Measures the cross-sectional area of the upper airway.
Pharyngometry
First choice of tx for obstructive sleep apnea.
CPAP
Procedure where polyester inserts stiffen the soft palate to stop snoring.
Pillar procedure
UPPP
Uvulopalatopharyngoplasty
Procedure where you cut out the uvula and soft palate to stop OSA.
Uvulupalatopharyngoplasty
UPPP is what percent successful?
40
OAT stands for:
Oral Appliance Therapy
OAT function
Stabilizes the mandible, tongue, and hyoid bone.
First line therapy for patients with snoring or mild to moderate obstructive sleep apnea.
Oral appliances
Can oral appliances be used for patients with SEVERE OSA, severe daytime sleepiness, or in patients who have very low oxygen saturation levels during sleep?
NO!
Allows you to measure the amount of protrusion.
George Gage
Oral appliances are less effective than what in improving sleep disordered breathing, and they take longer to achieve optimal treatment?
CPAP
Oral Appliance Therapy Contraindications
- Insufficient Dentition
- Periodontal Disease
- Dental Decay
- TMJ Pain
- Restricted mandibular opening or protrusion
OAT Side Effects
- Muscle and TMJ Pain
- Excess Salivation
- Early morning occlusal discomfort
- Tongue, Tooth, Gum discomfort
- Occlusal change in about 14% of patients after 5 years.