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RT-130B > Sleep Disorders > Flashcards

Sleep Disorders Flashcards

1
Q

What are the stages of sleep?

A

4 stages of non-rapid eye movement

Rem Sleep

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2
Q

How long does each cycle of sleep last?

A

100 mins
where non-rem predominates the earlier in the night
Rem sleep later

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3
Q

What is S in stopbang?

A

Snoring loudly?

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4
Q

What is T in stopbang?

A

Tired during day?

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5
Q

What is O in stopbang?

A

Observed apnea?

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6
Q

What is P in stop bang?

A

Pressure (elevated blood pressure)?

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7
Q

What is B in stop bang?

A

BMI more than 35

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8
Q

What is A in stop bang?

A

A Age more than 50

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9
Q

What is N in stop bang?

A

Neck circumference > 40cm

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10
Q

What is G in stopbang?

A

G for Gender male

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11
Q

What are cardiopulmonary consequences of OSA?

A 
Nocturnal arrhythmia
Systemic and pulmonary Hypertension
R or L ventricular failure
Myocardial infarction, Stroke
Elevated levels of C-reactive protein, homosteine and proinflammatory cytokines
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12
Q

What are neurological consequences of OSA?

A 
Excessive daytime sleepiness
Diminished quality of life
Adverse personality changes
MVAs
Stroke
Memory
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13
Q

What can happen if a patient with COPD also has OSA?

A

Significant hypercapnea, hypoxemia
Exacerbate underlying condition
Pts have worse prognosis than COPD w/o OSA

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14
Q

What is Central Sleep Apnea?

A

Apnea during sleep due to a loss of ventilatory drive

Pathophysiology poorly understood

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15
Q

What kind of breathing pattern would you observe in central Sleep apnea?

A

Often, patients have periodic breathing – episodes of hyperventilation followed apnea

Cheyne Stokes respiration is the extreme of this

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16
Q

How can you treat central sleep apnea?

A

use treatments that treat heart failure
this can reduce heart failure

CPAP
Oxygen

17
Q

What group of patients is likely to have central sleep apnea?

A

CHF

18
Q

What are types of sleep disorders?

A 
Apnea – Obstructive or Central
Insomnia (psychophysiologic/perimenopausal )
Circadian rhythm disorders
Sleep walking, nightmares 
Sleep paralysis
19
Q

What happens to our body in normal sleep?

A

Marked reduction in muscle tone
-Loss of accessory muscle use
The bodies metabolic rate slows
A decreased amount of CO2 is produced
Brainstem input to respiratory muscle drive is diminished
Chemoreceptor response is reduced
-Hypercapnic response is reduced by 20-50%

20
Q

What happens to our Ve in normal sleep?

A

Hypoventilation and hypercarbia in normal sleep

In Non-REM sleep, our minute ventilation is 0.5 – 1.5L lower
In REM sleep, minute ventilation is ~1.5L lower

21
Q

What is defined as apnea period?

A

complete cessation of flow for more than 10 seconds

22
Q

How do you diagnose OSA or CSA?

A

Medical History and Sleep questionnaires

Polysomnography (PSG) - Gold Standard
-in home (portable) or in LAB

Nocturnal Pulse Oximetry Screening

23
Q

What are the main sensors for a PSG?

A

Electroencephalogram –EEG - BRAIN

Electro-oculogram - EOG, - EYES

Chin electromyogram – EMG - CHIN

EKG - HEART

24
Q

What is the AHI and its ranges?

A

Total number of apneas and hypopneas divided by the number of hours of sleep

Diagnosis: more than 5 with symptoms, or more than 15 with or without symptoms

Mild: 5-20 / hr
Mod: 20-40 / hr
Severe:>40 / hr

25
Q

What is RERA?

A

The average number of episodes of apnea, hypopnea, and respiratory event-related arousals (RERA) per hour of sleep

Mild: 5-15 / hr
Moderate: 15-30 / hr
Severe: >40 / hr

26
Q

What are the Types of sleep study?

A

Type 1 - PSG
Type 2 - COMP - portable PSG
Type 3 - modified portable psg
Type 4 - least - only 2 monitors

27
Q

What are non-medical treatments to OSA?

A

Loss of weight

Avoidance of alcohol, sedatives and sleep deprivation
-Alcohol decreases the threshold for arousal, thus episodes are longer and worse

Positional therapy

  • The tennis ball cure
  • Side positioning
28
Q

What are pressures for CPAP with OSA?

A

7-12 commonly used

Determined by a CPAP titration study.

RT-130B (9 decks)

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