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Respiratory > Sleep Apnoea and Neuromuscular Respiratory Disorders > Flashcards

Sleep Apnoea and Neuromuscular Respiratory Disorders Flashcards

1
Q

What is the respiratory patters of a baby before 36 weeks?

A

Periodic, breathing for short periods

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2
Q

How much sleep should a newborn get?

A

16 - 18hrs

sleep-wake states alternate in 3-4hr cycles

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3
Q

At 6 months how much should a baby sleep?

A

14 -15hrs
1-2 daytime napps
2 longer sleeping periods

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4
Q

At 2 years how much should a child sleep?

A

12hrs

1 daytime nap

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5
Q

When is napping considered abnormal?

A

Up to around the age of 8 napping is normal

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6
Q

How is sleep assessed?

A 
Polysomnography 
Direct behavioural observation 
Movement sensors in cot mattress 
O2/CO2 monitoring
Time-lapse video
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7
Q

What sleep would be abnormal for a 1yr old?

A

Sleeping 8hrs at night with no naps

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8
Q

What are normal sleep phenomena?

A

Sleep walking
Sleep terrors
Hypnic jerks

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9
Q

What are the main reasons for sleeplessness in children?

A

Behavioural problems
Medication
Neurological disorders

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10
Q

What are the main reasons for excessive sleepiness in children?

A

Insufficient sleep
OSAS
Narcolepsy

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11
Q

What does Narcolepsy cause?

A

Cataplexy

Orexin deficiency

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12
Q

What is primary snoring?

A

Snoring without apnoea, hypoventilation, hypoxia, hypercarbia or daytime symptoms

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13
Q

What is the prevalence of primary snoring in children?

A

About 10%

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14
Q

What is the prevalence of OSAS in children?

A

About 2%

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15
Q

What are the morbidities of OSAS in children?

A

Failure to thrive
Neurocognetive defects
Systemic hypertension
Cor pulmonale

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16
Q

What are the possible treatment of OSAS in children?

A

Adenotonsillectomy
CPAP
Weight loss
Avoid tobacco smoke

17
Q

What are some common respiratory disorders in children?

A

Chronic neonatal lung disease
Cystic Fibrosis
Asthma

18
Q

What neurological disorders in children have an effect on the respiratory system?

A

Cerebral palsy
Down syndrome
Prader-Willi syndrome

19
Q

What is OSAS?

A

Obstructive sleep apnoea syndrome is recurrent episodes of upper airway obstruction leading to suspension of breathing during sleep

20
Q

How does OSAS effect patients?

A 
Heavy snoring 
Unrefreshing sleep 
Daytime somnolence 
Poor daytime concentration 
Increased risk of RTA 
Marital disharmony
21
Q

How can the upper airway be closed?

A

Narrow pharynx
Obesity
Muscle relaxation

22
Q

What is the prevalence of OSAS in adults?

A

2% men

1% women

23
Q

How is OSAS diagnosed?

A

Clinical history and examination
Epworth questionare
Overnight sleep study

24
Q

What does an overnight sleep study involve?

A

Pulso oximetry
Limited sleep studies
Full polysomnography

25
Q

what does oximetry measure?

A

Oxygen saturation

26
Q

What are the characteristics of a patients overnight oximetry with OSAS?

A

It varies massively and continuously through the night

27
Q

What is the scale of severity of OSAS?

A 
AHI - 
0-5 normal 
5-15 mild 
15-30 moderate 
>30 severe
28
Q

What does AHI show?

A

The number of apnoea or hypopnea per hour of sleep

29
Q

What is the treatment of OSAS in adults?

A

Identifying and dealing with exacerbating factors
CPAP
Mandibular repositioning splint

30
Q

What is the prevalence of narcolepsy?

A

0.05%

31
Q

When is narcolepsy usually diagnosed?

A

Teenage years or young adults

32
Q

What are the clinical features of narcolepsy?

A

Cataplexy
Excessive daytime somnolence
Hypnagogic hallucinations
Sleep paralysis

33
Q

What is the treatment for narcolepsy?

A

Modafinil
Clomipramine
Sodium Oxybate

34
Q

What is chronic ventilatory failure?

A

pCO2 > 6 kPA
pO2 < 8 KPA
Normal blood pH
Elevated bicarbonate

35
Q

What can cause chronic ventilatory failure?

A

Airway disease
Chest wall abnormalities
Respiratory muscle weakness
Central hypoventilation

36
Q

What are the symptoms of chronic ventilatory failure?

A 
Breathlessness 
Orthopnoea 
Ankle swelling 
Morning headache 
Recurrent chest infection 
Disturbed sleep
37
Q

Why investigations should be done to check for chronic respiratory failure in patients with neuromuscular disease?

A 
Lying and standing VC 
Mouth pressures/ SNIP  
Early morning ABG 
Overnight oximetry 
Transcutaneous CO2 monitoring 
Fluoroscopic screening of the diaphragm
38
Q

What is the treatment for chronic respiratory failure?

A

Domiciliary non invasive ventilation
Oxygen therapy
t-IPPV

39
Q

What can down syndrome cause?

A

OSAS

Respiratory (27 decks)

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