Sleep Apnea and Screening for Lung Cancer Flashcards
Obstructive Sleep Apnea
Due to obstruction of the upper airway
Central Sleep Apnea
Failure of the brain to initiate respiration
Obesity-Hypoventilation Syndrome
- Almost all also have OSA
- Hypo-ventilate even when awake
What is the chest effort in obstructive sleep apnea?
Preserved chest effort
What are some risk factors for central sleep apnea?
- CNS Disease
- Heart Failure
What is the chest effort in central sleep apnea?
It is halted along with the apnea
What is the diagnosis for sleep apnea?
Polysomnography
Apnea-Hypopnea Index
Anything greater than 5 episodes per hour is abnormal
What are some risk factors for obstructive sleep apnea?
- Obesity
- Neck Circumference (>17 in) Hypertension
- Male Gender
- Increasing Age
- Smoking
- Retrognathia
What is the main population affected by obstructive sleep apnea?
US White Males with BMI 25-28
What are some of the consequences of sleep apnea?
- Daytime Hypersomnolence
- Intellectual Impairment
- Pulmonary Hypertension
- Polycythemia
How does the treatment of OSA affect CHF?
It may improve CHF
What is the effect of OSA on BP?
It can lead to HTN - increased sympathetic nervous activity which will raise BP
What are some of the treatment options for sleep apnea?
- Weight Loss
- CPAP
What is the leading cause of cancer death in both men and women?
Lung Cancer
Why is lung cancer screening important?
To catch lung cancer early as most cases present very late which contributes to the mortality rate
Why was the USPSTF against lung cancer screening pre-1999?
Screening identified more cancers but had NO effect on mortality
What cancer study shifted the stance of the USPSTF on lung screening to indeterminate?
ELCAP which compared LDCT with CXR screening methods
What is the relationship between the size of a lung tumor and the chance of malignancy?
The larger the nodule the more chance it will be malignant
What is the current recommendation for lung cancer screening?
The USPSTF recommends annual screening for lung cancer with low-dose computed tomography in adults ages 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years.
