Sleep Apnoea and Neuromuscular Respiratory Disorders Flashcards
What does OSAS stand for?
Obstructive sleep apnoea syndrome
Define nacrolepsy
A condition characterized by an extreme tendency to fall asleep whenever in relaxing surroundings.
What is often a comon feature of patients suffering from narcolepsy?
Cataplexy - a medical condition in which strong emotion or laughter causes a person to suffer sudden physical collapse though remaining conscious.
What is primary snoring?
–snoring without apnea, hypoventilation, hypoxia, hypercapnea, daytime symptoms
What can primary snoring progress to?
OSAS
When is OSAS most common?
Pre-school child
What is the prevalence of OSAS?
2%
What are the associated morbidities with sleep apnoea?
Failure to thrive
Neurocognitive defects/adhd
Systemic hypertension
Cor Pulmonale
What is the difference between Adult versus Childhood OSAS?
What is the treatment for OSAS?
Adenotonsillectomy
CPAP - (Continuous positive airway pressure therapy (CPAP ) uses a machine to help a person who has obstructive sleep apnea (OSA) breathe more easily during sleep. ACPAP machine increases air pressure in your throat so that your airway doesn’t collapse when you breathe in)
Weight loss
Avoid environmental tobacco smoke
What are the respiratory disorders associated with sleep apnoea?
Chronic neonatal lung disease
–hypoxaemia in REM sleep (similar COPD)
–cardiac complications
Cystic Fibrosis
–FEV1 30-60% associated with decrease SaO2 (~8%)
–less REM/more awakenings
Asthma
What neuorlogical disorders are associated with sleep disorders?
Cerebral palsy
–fragmented sleep/delayed onset
–melatonin
Down Syndrome
–OSAS
Prader-Willi Syndrome
–excessive daytime sleepiness
•Neuromuscular disease (Duchenne’s MD)
–death due to respiratory failure
–nocturnal desaturation associated with FVC <1litre
–increasing quality of life/survival with BiPAP - Bilevel Positive Airway Pressure
What are the three types of sleep apnoea?
Obstructive sleep apnoea - caused by blockage in the upper airway
Central sleep apnea - brain fails to signal the muscles to breathe
Mixed apnoea - combination of above
Which type of sleep apnea is most common in infants and premature babies?
Central sleep apnea
Who often has mixed apnea?
SMaller premature babies
Who is most likely to have OSA?
Adults and children age 1 year and older
Why do children with Down Syndrome have a higher incidence of sleep apnea?
Condition affects the upper airway
In babies, what are the common causes of sleep apnea?
Immaturity of the brain stem - regulates breathing
Upper airway Obstruction
What are the other common causes of sleep apnea?
Bleeding in the brain
Exposure to drugs or poisons
Birth defect
INfection
Respiratory disaese
Gastrointestinal problems (like reflux)
Imbalance in body chemistry (incorrect amounts ofcalcium or glucose)
Problems with the heart or blood vessels
What is meant by periodic breathing?
An irregular breathing pattern
Typically starts with rapid breaths, then slower breaths, then a pause in breathing for five to 10 seconds. Then the pattern resumes with rapid breaths, and so on. Periodic breathing isn’t anything to worry about, and babies usually outgrow it by the time they’re about 6 months)
What are the symptoms of sleep apnea?
Some babies with sleep apnea stop breathing for 20 seconds or longer during sleep. Others stop breathing for shorter periods and become limp, turn pale or blue, or have a slowed heart rate as they sleep.
What is the test often used to diagnose sleep apnea?
Polysomnogram
What does polysomnogram consist of?
Procedure performed in a sleep lab.
Monitors brain waves, eye movements, breathing and oxygen level as well as snoring and gasping sounds.
What is sleeplessness caused by?
Behavioural problems
Medication
Neurological Disorders (melatonin)
Why are people who are narcoleptic often obese?
Narcolepsy can be caused by Orexin deficiency. Orexin is responsible for stimulating food intake, stimulates wakefulness, regulates energy expenditure, and modulates visceral function.
Orexin is needed for brown preadipocytes to differentiate into brown adipose tissue. Brown adipose tissue is responsible for thermogenesis. Therefore impaired thermogenesis and reduced energy expenditure.
