Sleep Apnoea Flashcards
What is sleep apnoea
Airway obstruction whilst asleep that lasts 10 seconds or more
What causes sleep apnoea
A loss of tone of muscles in the upper airway allowing the tongue to fall back and block the airway by occluding it against the back of the pharynx
Describe central sleep apnoea
Motivation to breathe from the brain is lost and therefore the breathing will stop even though the airway remains patent - small proportion
What is the consequence of sleep apnoea
The patient doesn’t sleep properly as they are having periods of hypoxia which causes, arousal, preventing them from properly relaxing
Hypoxia increases risk of an acute cardiac event such as an MI
What are the different types of sleep apnoea
Obstructive sleep apnoea
Central sleep apnoea
How is the severity of sleep apnoea measured
With an apnoea/hypopnoea index how many events the patient has in the way of airway obstruction every hour
What are the different treatments for sleep apnoea
Mandibular Advancement Appliance
CPAP - Continuous Positive Airway Pressure
How does a mandibular advancement appliance work
Can move the tongue away from the back of the pharynx
The tongue is attached to the front of the mandible so if the mandible is repositioned forwards, it pulls the tongue with it, making it more difficult for the tongue to obstruct the airway
What is the problem with a mandibular advancement appliance
It is very uncomfortable to wear as it puts significant pressure onto the gingivae of the upper anterior and lower lingual regions
Describe CPAP
Patient wears a mask which doesn’t ventilate, but keeps a certain amount of pressure within the airway at all times
This pressure blows apart the tongue and the pharynx keeping the airway patent and allowing the patient to breathe
How is a mandibular advancement appliance used
Patient puts them on the upper and lower arch, protrude the mandible as far forward as possible and the blocks will be sealed together, leaving a gap so the patient can still breathe
To put on, fit the upper appliance, then move the mandible forward to fit the lower appliance
How is a CPAP machine fitted
Mask fits mouth and nose and is connected by pipework
When is sleep apnoea positional therapy used
When a patient sleeps on their back
Describe how positional therapy works
Device has carrying modules designed to prevent patients from rolling over and lying on their back
How can positional therapy be carried out without a device
Using pillows to mould the body into a certain position can trap the patient onto their side so they don’t roll over onto their back
