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Respiratory > Sleep Apnea > Flashcards

Sleep Apnea Flashcards

1
Q

Who are more likely to have sleep apnea?

A

Women
AA
Hispanics

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2
Q

What is the sleep wake cycle?

A

During sleep, the brain displays several different stages of electrical activity

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3
Q

How do we measure the sleep wake cycle?

A

EEG

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4
Q

What are the stages of NREM?

A

Stage 1 have the lowest amplitude and highest frequency

Stage 3 has the highest amplitude and lowest frequency

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5
Q

When does HR and BP decrease during sleep?

A

Stage 3 of NREM

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6
Q

When does HR and BP increase during sleep?

A

REM

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7
Q

When does GI motility increase during sleep?

A

Stage 3 NREM

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8
Q

What happens during REM?

A

Skeletal muscle (except those that control the eyes) are completely inhibited from moving

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9
Q

When does visual dreaming occur?

A

REM

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10
Q

What is a normal breath rate?

A

12-16 BMP

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11
Q

What are dyssomnias?

A

Primary disorder of initiating or maintaining sleep or of excessive sleepiness

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12
Q

How is dyssomnia characterized?

A

Disturbance in the amount, quality, or timing of sleep

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13
Q

What is parasomnias?

A

Unusual or undesirable behavior or physiologic events that occurs during sleep or at the threshold between waking and sleeping

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14
Q

What is apnea?

A

Cessation of airflow for 10 or more seconds

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15
Q

What is hypopnea?

A

30% reduction in airflow for 10 or more seconds associated with a 4% decrease in oxygen saturation

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16
Q

What is the AHI?

A

Apnea-hypopnea Index

Number of apnea and hypopnea episodes per hour

17
Q

What is OSA in the AHI?

A

15+ events/hr w/ or w/o sx
or
5+ events w/sx

18
Q

What is OSA?

A

Cessation of airflow despite continued respiratory effort

19
Q

What is central sleep apnea?

A

Cessation of airflow with no respiratory effort

20
Q

What are the characteristics of OSA?

A

Continued respiratory effort
Collapse in tissue near the throat
Snoring
Fragmented sleep and daytime somnolence

21
Q

What are the characteristics of CSA?

A 
Less common, more serious
No respiratory effort
Common in patients w/HF and CVD
No snoring
Fragmented sleep and daytime somnolence
22
Q

What happens to the muscles in OSA?

A

Skeletal muscle of the tongue, larynx and pharynx relax as well as smooth muscle in the upper airways

23
Q

What are long term effects of OSA?

A

HTN
CVD
Stroke
Higher mortality

24
Q

What are the etiologies of OSA?

A 
HTN
Pulmonary do (pulmonary HTN)
Cardiac do
Diabetes
Mortality and accidents
25
Q

What are the clinical findings of OSA?

A 
Obesity
Large neck circumference
Dental overbite; malocclusion
Edema, erythema, of the uvula
Elongated and low-hanging soft palate
Narrow mandible; narrow maxilla
Tonsillar hypertrophy
Adenoid hypertrophy
Nasal septal deviation
26
Q

What are RFs for OSA?

A 
Obesity
Neck circumference (17+ men, 15+ women)
Male
FH
AA, Pacific islander, mexican american)
Downs syndrome
40+ yo
Postmenopausal status
EtOH before bed
Respiratory allergies and nasal congestion
HTN
27
Q

What are daytime sx of OSA?

A 
Daytime sleepiness and fatigue
Morning or nocturnal HA
Impaired memory and concentration
Decreased dexterity
Personality changes
28
Q

What are nocturnal sx of OSA?

A 
Snoring
Nocturnal choking
Nocturnal snorting and gasping
Restlessness
Dyspnea
Diaphoresis
Nocturia
Dry mouth
Drooling
Gastroesophageal reflux
29
Q

What is the gold standard for OSA?

A

Overnight polysomnogram

AHI 5+ events per hour

30
Q

What questionnaire can be used for OSA?

A

STOP BANG
Berlin
Epworth sleepiness scale

31
Q

What is mild OSA?

A

5-14 events/hr

32
Q

What is moderate OSA?

A

15-29 events/hr

33
Q

What is severe OSA?

A

30 or more events/hr

34
Q

What is the treatment of OSA?

A 
Wt loss
Avoid sleep deprivation
Refrain from tobacco, alcohol, and sedative use
Sleep position (avoid back)
Good sleep hygiene
CPAP
35
Q

When is CPAP used in OSA?

A

Possibly mild OSA

Moderate - severe OSA definitely (possible surgical interventions)

36
Q

What are the characteristics of CSA?

A

Periodic episodes of apnea caused by loss of ventilatory motor output

37
Q

What are causes of CSA?

A 
Idiopathic
ANS lesions
Neurologic dz
CH
Opioid abuse
High altitudes
38
Q

What are tx for snoring?

A 
Wt loss
Nasal decongestants
Drugs to reduce upper airway inflammation
Avoid etoh
Smoking cessation
Positional therapy
CPAP

Respiratory (8 decks)

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