Sleep Apnea

Question 1

A diagnosis of sleep apnea is made how?

Answer 1

Epworth sleepiness scale
History and examination
Polysomnography – desaturations (6-30+)

Question 2

What causes the sleepiness in sleep apnea?

Answer 2

Microarousals during sleep due to obstruction of the airway – daturation

Question 3

Investigations for sleep apnea?

Answer 3

Pulse oximetry
Full polysomnography
- Airflow
- O2 sat
- Movement
- ECG,EMG,EOG,EEG

Question 4

Exacerbating factors for sleep apnea?

Answer 4

Obesity
Alcohol
Endocrine disorders

Question 5

Management for sleep apnea

Answer 5

Reduce exacerbating factors
CPAP
Mandibular repositioning splint
SHOULD NOT DRIVE

Question 6

Presentation of Narcolepsy

Answer 6

Cataplexy
Excessive daytime somnolence
Hypnagogic hallucinations
Sleep paralysis

Question 7

Treatment of narcolepsy

Answer 7

Modafinil
Clomipramine
Sodium Oxybate

Question 8

Investigative results of Chronic Ventilation Failure

Answer 8

Increased PaCO2, decreased PaO2
Normal blood pH
Elevated bicarbonate

Question 9

Causes of Chronic Ventilation failure

Answer 9

Airways disease
Kyphoscoliosis
Respiratory muscle weakness
Hypoventilation syndrome (Central or obesity)

Question 10

Symptoms of Chronic Ventilation failure

Answer 10

SoB, Orthopnoea
Ankle swelling, cor pulmonale
Morning headache
Recurrent chest infections
Disturbed sleep

Question 11

Investigation for Chronic Ventilation failure

Answer 11

LFT - lying/standing V/
Assess hypoventilation
    - Morning ABG
    - Overnight oximetry
Diaphragm fluoroscopy

Question 12

Treatment for Chronic Ventilation failure

Answer 12

NIV
O2 therapy
t-IPPV

Question 13

Normal sleep pattern <36w

Answer 13

Intermittent (3/4 sleep wake cycles)

Question 14

Assessment for childhood sleep apnea

Answer 14

Polysomnography
Observe behaviour
O2/CO2 monitor

Question 15

Treatment for childhood sleep apnea

Answer 15

Adenotonsillectomy (if necessary)
CPAP
Avoiding tobacco smoke
Weight loss