Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory > Sleep disorders > Flashcards

Sleep disorders Flashcards

1
Q

What is Cheyne-Stokes respiration?

A

Central apnoea/hypopnoea alternating with respiratory phase of crescendo-decrescendo pattern of flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are risk factors for OSA and AHI>15?

A
  1. Elevated BMI (strongest risk factor)
  2. Male sex
  3. Older age
  4. Neck circumference (men >43cm, women >37cm)
  5. Snoring
  6. Witnessed apnoeas
  7. Menopausal women
  8. Craniofacialabnormalities
  9. High Mallampati score (2 fold increase in risk of OSA with each increase in MP score)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pathophysiology of narcolepsy

A

Autoimmune destruction of hypothalamic neurones that produce hypocretin which regulates arousal and sleep/wake cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the definition of AHI?

A

Apnoea-Hypopnoea Index:

Number of these events per hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the two types of sleep?

A

REM and non-REM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What proportion of total sleep does REM constitute?

A

~20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the definition of apnoea?

A

Cessation of airflow for >= 10s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the definition of hypopnoea?

A

Reduction in airflow by 30% for >= 10 seconds followed by:

  1. desaturation of 4%, or,
  2. EEG arousal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sleep Foundation Survey (Australia, 2016)

A

8.3% Australian Adults have OSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is RERA?

A

Respiratory effort related arousal:
Events of increased respiratory effort for >=10 seconds associated with EEG arousal but not meeting criteria for hypopnoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is RDI?

A

Respiratory disturbance index:

AHI plus RERAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Approach to narcolepsy

A 
Sleep study to exclude other causes
Urine drug screen
Mean sleep latency test (MSLT)
-series of naps set 2 hours apart
-MSLT of <8 minutes associated with onset of REM periods is highly suggestive of narcolepsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What constitutes non-REM sleep?

A

Divided into N1/N2/N3

Progressively “deeper” sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the treatment for narcolepsy?

A

Dexampheatmines or modafinil / armodafinil

Treat cataplexy with SSRI/SNRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is narcolepsy?

A

Intrusion of REM-sleep into wakefulness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

OSA treatments

A 
Risk factor modification
CPAP
Oral appliances
Surgery (tonsillectomy, bariatric surgery)
Maxillofacial surgery - rarely used
17
Q

What is a sleep epoch?

A

30 seconds of sleep recording

18
Q

What are the types of narcolepsy?

A

Type 1 - Excessive daytime sleepiness for >3months and either:

  1. cataplexy and positive mean sleep latency test (MSLT) or
  2. low CSF hypocretin

Type 2
Excessive daytime sleepiness >3 months
Cataplexy is absent
Positive MSLT with normal CSF hypocretin

Requires exclusion of other causes of sleepiness

19
Q

What is the treatment for OHS?

A

CPAP or NIV

consider NIV up-front if primary ventilatory failure without significant OSA

20
Q

How many types of sleep study are there? What do they entail?

A

4 types
Type 1 - polysomnography (lab study), measures over 7 metrics
Type 2 - home study, measures at least 7 metrics
Type 3 and 4 - limited studies for screening for OSA

21
Q

Can you use the Epworth slepiness scale to diagnose OSA?

A

No, it measures sleepiness

22
Q

What sleep disordered breathing types occur in heart failure?

A

OSA and cheyne stokes respiration

23
Q

What is central sleep apnoea?

A

Reduction / cessation in airflow due to absent or reduced respiratory effort

24
Q

What is STOP BANG?

A 
Screening tool for OSA
Snoring
Tiredness
Observed apnoeas
Blood Pressure
BMI
Age
Neck circumference
Gender
25
Q

What is N3, non-REM sleep also referred as?

A

Slow-wave sleep

26
Q

What are the characteristics of REM sleep?

A

Atonia (detected by EMG)

Tonic/Phasic eye movements (detected by EOG)

27
Q

PICKWICK trial

A

N 215, randomised to CPAP or NIV
3 years follow up
No significant difference in outcomes

28
Q

What is the pathophysiology of OHS?

A

Reduced lung volumes, respiratory muscle weakness, reduced chest wall compliance, leptin resistance, serum bicarb
Results in blunted respiratory drive

29
Q

What is the theshold for increased neck circumference?>

A

Men>43cm

Women >37cm

30
Q

What is the all cause mortality of OHS at 2 years?

A

24%

31
Q

What is the treatment for sleep disordered breathing in heart failure?

A

Optimise medical therapy
OSA - CPAP may improve EF, BP, exercise capacity and QOL
Cheyne stokes - CPAP, oxygen or BiPAP

**Adaptive servo ventilation (ASV) increases mortality in HF patients with cheynestokes

32
Q

What is cataplexy?

A

Sudden, transient loss of skeletal muscle tone, usually triggered by laughter in narcolepsy type 1

33
Q

What is sleep hypoventilation?

A

Uses transcutaneous CO2 monitoring

Rise of CO2 >=10mmHg to above 55mmHg above baseline

34
Q

What are the benefits of CPAP?

A

Improved sleepiness, QOL, depression, cognitive function, reduced hypertension, reduces risk of MVA.

35
Q

What percentage of people continue to use CPAP beyond 5 years?

A

65%

36
Q

What is obesity hypoventilation syndrome?

A

OHS
Awake hypercapnia
BMI >30
Sleep disordered breathing without other lung disease

37
Q

What is the increased risk of motor vehicle accidents in those with moderate/severe OSA?

A

4x increased risk

38
Q

Does OSA increase all cause mortality?

A

Yes, 3x with severe OSA

39
Q

What effect does OSA have on AF?

A

Higher symptom burden, antiarrythmic use, hospitalisation due to AF
No increase in AF related mortality

Respiratory (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions