Sleep Apnea and Screening for Lung Cancer

Question 1

Obstructive Sleep Apnea

Answer 1

Due to obstruction of the upper airway

Question 2

Central Sleep Apnea

Answer 2

Failure of the brain to initiate respiration

Question 3

Obesity-Hypoventilation Syndrome

Answer 3

-􏰃 Almost all also have OSA

􏰃- Hypo-ventilate even when awake

Question 4

What is the chest effort in obstructive sleep apnea?

Answer 4

Preserved chest effort

Question 5

What are some risk factors for central sleep apnea?

Answer 5

• CNS Disease

- Heart Failure

Question 6

What is the chest effort in central sleep apnea?

Answer 6

It is halted along with the apnea

Question 7

What is the diagnosis for sleep apnea?

Answer 7

􏰃Polysomnography

Question 8

Apnea-Hypopnea Index

Answer 8

Anything greater than 5 episodes per hour is abnormal

Question 9

What are some risk factors for obstructive sleep apnea?

Answer 9

• Obesity
  -􏰃 Neck Circumference (>17 in) 􏰃 Hypertension
  􏰃- Male Gender
  􏰃- Increasing Age
  􏰃- Smoking
  􏰃- Retrognathia

Question 10

What is the main population affected by obstructive sleep apnea?

Answer 10

US White Males with BMI 25-28

Question 11

What are some of the consequences of sleep apnea?

Answer 11

-􏰃 Daytime Hypersomnolence 􏰃
- Intellectual Impairment
- Pulmonary Hypertension
􏰃- Polycythemia

Question 12

How does the treatment of OSA affect CHF?

Answer 12

It may improve CHF

Question 13

What is the effect of OSA on BP?

Answer 13

It can lead to HTN - increased sympathetic nervous activity which will raise BP

Question 14

What are some of the treatment options for sleep apnea?

Answer 14

• Weight Loss

- CPAP

Question 15

What is the leading cause of cancer death in both men and women?

Answer 15

Lung Cancer

Question 16

Why is lung cancer screening important?

Answer 16

To catch lung cancer early as most cases present very late which contributes to the mortality rate

Question 17

Why was the USPSTF against lung cancer screening pre-1999?

Answer 17

Screening identified more cancers but had NO effect on mortality

Question 18

What cancer study shifted the stance of the USPSTF on lung screening to indeterminate?

Answer 18

ELCAP which compared LDCT with CXR screening methods

Question 19

What is the relationship between the size of a lung tumor and the chance of malignancy?

Answer 19

The larger the nodule the more chance it will be malignant

Question 20

What is the current recommendation for lung cancer screening?

Answer 20

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.