Sleep Apnoea and Narcolepsy Flashcards
What is obstructive sleep apnoea syndrome?
Recurrent episodes of upper airway obstruction leading to apnoea during sleep
Define apnoea
Temporary cessation of breathing, especially during sleep.
What is sleep apnoea usually associated with?
Heavy snoring
What can sleep apnoea lead to during the day?
Difficulty concentrating
Sleepiness
Which factors may lead to the upper airway become closed repeatedly/obstructed?
Muscle relaxation
Narrow pharynx
Obesity
What can the repetitive closing/obstruction of the upper airway cause?
Snoring
Oxygen desaturation
What is it called when the airway is obstructed for ten seconds or more?
Apnoea
What is is called the airway is nearly obstructed for ten seconds or more?
Hypopnea
What is meant by a micro arousal?
Switching from deep sleep to light sleep
Why is sleep apnoea an issue?
Impaired quality of life
Marital disharmony- due to heavy snoring, lack of engagement during evenings etc
Increase risk of road traffic accidents
What is obstructive sleep apnoea syndrome associated with?
Hypertension
Increased risks of stroke
Increased risks of heart disease
Name the three parts of a diagnosis of sleep apnoea.
Clinical history and examination
Epworth Questionnaire
Overnight sleep study
Briefly describe what happens during an Epworth questionnaire.
The patient gives themselves a score from 0 (no chance) to 3 (high chance) of them falling asleep in eight different situations
Above which score in the Epworth Questionnaire is considered to be abnormal?
11 or above
Give some examples of the situations patients are asked if they would fall asleep in.
Sitting and reading
Watching TV
Sitting inactive in a public place (meeting, cinema, etc.)
As a passenger in a car for more than an hour
Lying down to rest in the afternoon
Sitting and talking to someone
Sitting quietly after lunch without any alcohol
In a car stopped for a few minutes in traffic
->btw I just put these in for interest, idk if we need to know them but maybe if you just get the general picture :)
What is the most basic form of sleep study carried out?
Overnight oximetry
What does overnight oximetry measure?
Oxygen saturation and pulse throughout the night
Name the most sophisticated sleep study
Polysomnography
Is polysomnography usually required?
No, often simpler studies are just as useful
Name the way that obstructive sleep apnoea can be graded by severity
Desaturation rate or AHI (apnea-hypopnea index)
What is the apnea-hypopnea index?
Total number of apnoea’s and hypopneas divided by the total hours of sleep
What would a AHI score of 0-5 indicate?
Normal
What would a AHI score of 5-15 indicate?
Mild
What would a AHI score of 15-30 indicate?
Moderate
What would a AHI score of >30 indicate?
Severe
Name some of the management factors of OSA that a patient can do for themselves.
Weight reduction
Avoidance of alcohol
Which endocrine disorders may be present in those w OSA?
Hypothyroidism and acromegaly
What is the main treatment offered for OSA?
Continuous positive airways pressure (CPAP)
If a patient cannot tolerate Continuous positive airways pressure (CPAP), what is an alternative treatment?
Mandibular repositioning splint
What is it important to advise patients w OBA to do?
Avoid/restrict driving and let the DVLA know of their condition
When could someone w OBA be allowed to drive?
After satisfactorily treated
What is narcolespy?
A rare long-term brain condition that can prevent a person from choosing when to wake or sleep.
List some of the clinical features of narcolepsy.
Cataplexy
Excessive daytime sleepiness
Hypnagogic / hynopompic hallucinations
Sleep paralysis
What is cataplexy?
Sudden muscular weakness, often triggered by emotions like crying or laughing
What are some investigations used to diagnose narcolepsy?
PSG
MSLT (multiple sleep latency test)
Low CSF orexin
Briefly describe what goes on in a MSLT test
Put the patient in a darkened room about five times a day and advise them to try and fall asleep while measuring their brain waves and the time it takes them to fall asleep
