Sleep apnoea and respiratory neuromuscular disorders Flashcards
What is OSAS?
Obstructive sleep apnoea disorder
Condition characterised by recurrent episode of upper airway obstruction leading to temporary cessation of breathing while sleeping
What are the effects of sleep apnoea on a sufferer?
Un-refreshing sleep leading to daytime somnolence and poor concentration
Poorer quality of life
Increased risk of RTA’s (crashes)
Increased risk of stroke, heart disease and hypertension
What group of people are prone to having sleep apnoea?
The obese
What is the prevalence of OSAS amongst men and women?
2% of men
1% of women
How is OSAS diagnosed?
Clinical history + examination
Epworth questionnaire
Overnight sleep study
What is the Epworth questionnaire?
Questionnaire were patients rate how likely they are to doze off in certain situations out of 0, 1, 2 or 3 (highest)
In what 3 ways can a sleep study be carried out?
Overnight oximetry
Limited sleep studies - embletta
Full polysomnography
The severity of OSAS is based on the….
Desaturation rate
A patient with a desaturation rate of 0-5 is…
Normal
A patient with a desaturation rate of 15-30 has …
Moderate OSAS
A patient with a desaturation rate of 40 has…
Severe OSAS
>30 is severe
A patient with mild OSAS would have a saturation rate of…
5 - 15
How is OSAS treated?
Identify and treat exacerbating factors (weight, alcohol, endocrine disorders)
Continuous positive airways pressure (CPAP) machine
Mandibular repositioning splint (looks like a gumshield)
Why must the DVLA be informed of someones diagnosis with OSAS?
Severe impairment of ability to drive
What is narcolepsy?
Disorder where there is a lack of control of sleeping, and the sufferer may fall asleep at inappropriate times
What is the prevalence of narcolepsy?
0.05%
Narcolepsy is associated with what genes in the body?
HLA - DRB11501 and HLA DQB1 0602
What are the clinical features of narcolepsy?
Daytime somnolence with random, sudden sleeping
Hypnagogic hallucinations
Sleep paralysis
Cataplexy (sometimes)
How is narcolepsy treated?
Modafinil (which is good shit)
Clomipramine (for cataplexy)
Sodium oxybate (Xyrem)
What are the conditions for a patient to have chronic ventilatory failure?
pCO2 of >6.0 kPa
pO2 <8.0 kPa
Normal blood pH
Elevated blood bicarbonate
What conditions might be responsible for chronic ventilatory failure?
Airway diseases - COPD, bronchiectasis, OSA
Chest wall abnormalities - kyphoscoliosis
Respiratory muscle weakness - muscular dystrophy or motor neurone disease (ALS)
Central hypoventilation - obesity hypoventilation syndrome, central hypoventilation syndrome (Ondine’s curse)
What are the symptoms of chronic ventilatory failure?
Breathlessness Orthopnoea Ankle oedema Morning headache Recurrent chest infections Disturbed sleep
What is orthopnoea?
Breathlessness when lying flat
What is NIV?
(Domicillary) non invasive ventilation
Used for treatment of CVF due to neuromuscular disease
t-IPPV is basically what?
Mechanical ventilation machine thingy
