Sleep Apnoea and Narcolepsy Flashcards

1
Q

What is obstructive sleep apnoea syndrome?

A

Recurrent episodes of upper airway obstruction leading to apnoea during sleep

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2
Q

Define apnoea

A

Temporary cessation of breathing, especially during sleep.

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3
Q

What is sleep apnoea usually associated with?

A

Heavy snoring

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4
Q

What can sleep apnoea lead to during the day?

A

Difficulty concentrating
Sleepiness

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5
Q

Which factors may lead to the upper airway become closed repeatedly/obstructed?

A

Muscle relaxation
Narrow pharynx
Obesity

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6
Q

What can the repetitive closing/obstruction of the upper airway cause?

A

Snoring
Oxygen desaturation

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7
Q

What is it called when the airway is obstructed for ten seconds or more?

A

Apnoea

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8
Q

What is is called the airway is nearly obstructed for ten seconds or more?

A

Hypopnea

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9
Q

What is meant by a micro arousal?

A

Switching from deep sleep to light sleep

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10
Q

Why is sleep apnoea an issue?

A

Impaired quality of life
Marital disharmony- due to heavy snoring, lack of engagement during evenings etc
Increase risk of road traffic accidents

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11
Q

What is obstructive sleep apnoea syndrome associated with?

A

Hypertension
Increased risks of stroke
Increased risks of heart disease

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12
Q

Name the three parts of a diagnosis of sleep apnoea.

A

Clinical history and examination
Epworth Questionnaire
Overnight sleep study

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13
Q

Briefly describe what happens during an Epworth questionnaire.

A

The patient gives themselves a score from 0 (no chance) to 3 (high chance) of them falling asleep in eight different situations

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14
Q

Above which score in the Epworth Questionnaire is considered to be abnormal?

A

11 or above

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15
Q

Give some examples of the situations patients are asked if they would fall asleep in.

A

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 :)

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16
Q

What is the most basic form of sleep study carried out?

A

Overnight oximetry

17
Q

What does overnight oximetry measure?

A

Oxygen saturation and pulse throughout the night

18
Q

Name the most sophisticated sleep study

A

Polysomnography

19
Q

Is polysomnography usually required?

A

No, often simpler studies are just as useful

20
Q

Name the way that obstructive sleep apnoea can be graded by severity

A

Desaturation rate or AHI (apnea-hypopnea index)

21
Q

What is the apnea-hypopnea index?

A

Total number of apnoea’s and hypopneas divided by the total hours of sleep

22
Q

What would a AHI score of 0-5 indicate?

23
Q

What would a AHI score of 5-15 indicate?

24
Q

What would a AHI score of 15-30 indicate?

25
What would a AHI score of >30 indicate?
Severe
26
Name some of the management factors of OSA that a patient can do for themselves.
Weight reduction Avoidance of alcohol
27
Which endocrine disorders may be present in those w OSA?
Hypothyroidism and acromegaly
28
What is the main treatment offered for OSA?
Continuous positive airways pressure (CPAP)
29
If a patient cannot tolerate Continuous positive airways pressure (CPAP), what is an alternative treatment?
Mandibular repositioning splint
30
What is it important to advise patients w OBA to do?
Avoid/restrict driving and let the DVLA know of their condition
31
When could someone w OBA be allowed to drive?
After satisfactorily treated
32
What is narcolespy?
A rare long-term brain condition that can prevent a person from choosing when to wake or sleep.
33
List some of the clinical features of narcolepsy.
Cataplexy Excessive daytime sleepiness Hypnagogic / hynopompic hallucinations Sleep paralysis
34
What is cataplexy?
Sudden muscular weakness, often triggered by emotions like crying or laughing
35
What are some investigations used to diagnose narcolepsy?
PSG MSLT (multiple sleep latency test) Low CSF orexin
36
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