Sleep Apnea FINAL

Question 1

Obstructive Sleep Apnea is defined as

Answer 1

Breathing stops during sleep for greater than 10 seconds and at least 5 times/hr

Question 2

Apnea leads to __________ gas exchange (hypoxemia), __________ blood CO2 levels (hypercapnia), __________ pH causing the sleeper to wake up & correct obstruction. Cycle repeats throughout the night.

Answer 2

Apnea leads to decreased gas exchange (hypoxemia), increased blood CO2 levels (hypercapnia), decreased pH causing the sleeper to wake up & correct obstruction. Cycle repeats throughout the night.

Question 3

What is the cause of OSA?

Answer 3

Upper airway obstruction by the soft palate or tongue

Question 4

Expected OSA findings

Answer 4

-snoring
-excessive daytime sleepiness
-inability to concentrate
-irritability
-bedwetting or excessive urination at night
-reduced sex drive
-fatigue
-depression
-pharyngeal edema
-Chronic OSA: increased risk of HTN, stroke, cognitive deficits, weight gain, DM, pulmonary and CV disease

Question 5

OSA risk factors

Answer 5

obesity, large uvula, short neck, smoking, enlarged tonsils or adenoids, oropharyngeal edema

Question 6

Diagnostics for OSA

Answer 6

-STOP Bang Sleep Apnea questionnaire (score >3 indicates high risk)
-Pulmonary function tests (PFTs)
-Overnight sleep study (Polysomnography)

Question 7

Meds for OSA

Answer 7

Modafinil

Not the first line of therapy. Promotes daytime wakefulness. Does not treat OSA cause. May also help pts with narcolepsy.

Question 8

Surgical management of OSA

Answer 8

Adenoidectomy, uvulectomy, or uvulopalatopharyngoplasty

Severe cases may need trach.

Question 9

Non-surgical management of OSA

Answer 9

Change of sleep position, weight loss, decrease alcohol use, positive pressure ventilation, avoiding sedating meds, breathing machines