Sleep Apnoea Flashcards
What is sleep apnoea?
The intermittent closure of the pharyngeal airway causing apnoeic episodes during sleep, terminated by partial arousal
Pathophysiology (3 things)
Muscle relaxation
Narrow pharynx
Obesity
All lead to repeated closure of upper airway, which reduces oxygen saturation and leads to apnoeas
Associated risks/complications
Hypertension, stroke, heart disease, road traffic accidents
Risk factors
Male
Obese
Age
Endocrine disorder
Investigations
Epworth questionnaire
Overnight sleep study
What does pulse oximetry measure
Oxygen saturation
Name an overnight sleep study
Polysomnography
What does polysomnography measure
Oronasal airflow thoracoabdominal movement oximetry body position EEC EOG ECG EMG
What score indicates mild, moderate and severe obstructive sleep apnoea?
mild: 5-15
moderate: 15-30
severe: >30
Management of exacerbating factors
weight reduction
avoidance of alcohol
treat endocrine disorders
Treatment
CPAP (continuous positive airways pressure)
Mandibular repositioning splint
Clinical features of narcolepsy
Cataplexy - sudden physical collapse in extreme emotion
Excessive daytime somnolence
Hypnagogic hallucinations
Sleep paralysis
Treatment of narcolepsy
Modafinil
Clomipramine
Sodium oxybate
What is chronic ventilatory failure
Elevated pCO2, lowered PO2, elevated bicarbonate, normal blood pH
Aetiology of chronic ventilatory failure
Airways disease
Chest wall abnormalities
Respiratory muscle weakness
Central hypoventilation
