Sleep Disorder Breathing Flashcards
4 respiratory stimuli
high CO2, low O2, acid level, lack of stretch from lung stretch receptors
what is cheyne stokes breathing
crescendo decrescendo pattern w/ apnea in b/w, seen in brain or heart disease, hyperventilatory state
breathing rhythm w/ damage to lower medulla
total lack of rhythm
body response to O2 sat or tidal CO2 during sleep
less change in ventilation, esp in REM there is very little response
resp muscle tone in sleep
decreases during descent to deeper stages, atonia in REM (except diaphragm and a few others)
breathing pattern in sleep
periodic early on, becomes regular/steady, then irregular and periodic w/ apneas during REM
3 sleep related breathing disorders
sleep apnea (obstructive, central or mixed), cheyne stokes, hypoventilation
define sleep apnea
repetive episodes of diminished air flow associated w/ oxygen desat or arousal
contrast obstructive and central apnea
both have cessation of airflow, in obstructive there is continued changes in intrathoracic pressue- not so in central (no neural signalling)
cause of snoring
turbulent flow through airways
apnea hypopnea index
A+H/ sleep time- used to determin severity
who to evaluate for OSA
snoring w/ comorbidities like HTN, obesity, DM
snoring w/ sleepy Sx
children who snore and have daytime Sx
Dx of OSA
polysomnography- sleep state and physiology
gold standard is esophageal pressure, next best is intranasal pressure
causes of central sleep apnea
primary lesion of medulla/pons, related to meds like narcotics
Rx for central sleep apnea
CPAP, resp stimulants. O2
CPAP to raise CO2 and stretch stimuli for ventilation
