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YR 1 Respiratory > sleep apnoea, narcolepsy and neuromuscular ventilatory failure > Flashcards

sleep apnoea, narcolepsy and neuromuscular ventilatory failure Flashcards

1
Q

What is Obstructive Sleep Apnoea Syndrome?

A

•Recurrent episodes of upper airway obstruction leading to apnoea during sleep

  • Usually associated with heavy snoring
  • Typically unrefreshing sleep
  • Daytime somnolence /sleepiness
  • Poor daytime concentration
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2
Q

Pathophysiology of sleep apnoea

A
  • relaxed muscles
  • narrow pharynx
  • obesity
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3
Q

how is sleep apnoea diagnosed

A
  • Clinical history and exam
  • Clinical history and examination
  • Epworth Questionnaire
  • Overnight sleep study

–pulse oximetry

–limited sleep studies

–full polysomnographymination•Epworth Questionnaire•Overnight sleep study–pulse oximetry–limited sleep studies–full polysomnography

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4
Q

treatment for sleep apnoea

A

•Identify exacerbating factors

–weight reduction, avoidance of alcohol, diagnose and treat endocrine disorders e.g. hypothyroidism, acromegaly

  • Continuous positive airways pressure(CPAP)
  • Mandibular repositioning splint
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5
Q

clinical features of sleep apnoea

A
  • Cataplexy
  • Excessive daytime somnolence
  • Hypnagogic / hynopompic hallucinations
  • Sleep paralysis
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6
Q

diagnosis of narcolepsy

A
  • polysomnography
  • MSLT (>1 SOREM and mean sleep latency <8 min).
  • Low CSF orexin.•Low CSF orexin
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7
Q

treatment for narcolepsy

A
  • Modafinil
  • Dexamphetamine
  • Venlafaxine (for cataplexy)
  • Sodium Oxybate (Xyrem)
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7
Q

treatment for narcolepsy

A
  • Modafinil
  • Dexamphetamine
  • Venlafaxine (for cataplexy)
  • Sodium Oxybate (Xyrem)
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8
Q

signs of chronic ventilatory failure

A
  • Elevated pCO2(> 6.0 kPA)
  • pO2< 8 kPA
  • Normal blood pH
  • Elevated bicarbonate (HCO3-)
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9
Q

symptoms of chronic ventilatory failure

A
  • Breathlessness
  • Orthopnoea
  • Ankle swelling
  • Morning headache
  • Recurrent chest infections
  • Disturbed sleep
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10
Q

signs of a weak diaphragm in neuromuscular disease

A

paradoxical abdominal wall motion

abdomen moves down instead of up during inspiration

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11
Q

assessment of neuromuscular disease ventilation

A

•Lung function

–Lying and standing VC

–Mouth pressures / SNIP

•Assessment of Hypoventilation

–Early morning ABG

–Overnight oximetry

–transcutaneous CO2monitoring

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12
Q

treatment of ventilatory failure in neuromuscular disease

A
  • Domicillary Non Invasive Ventilation (NIV)
  • Oxygen therapy
  • tracheostomy
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13
Q

sleep apnoea severity: normal

A

0-5 desaturations

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14
Q

sleep apnoea severity: mild

A

5-15 desaturations

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15
Q

sleep apnoea severity: moderate

A

15-30 desaturations

16
Q

sleep apnoea severity: severe

A

over 30 desaturations

YR 1 Respiratory (15 decks)

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