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BPT Respiratory > Sleep Disorders > Flashcards

Sleep Disorders Flashcards

1
Q

What is Cheyne Stokes respiration?

A

recurrent central apnoeas/hypopneas alteranting with a respiratory phase exhibiting a crescendo-decrescendo pattern of flow, most commonly caused by CCF or neurological disorder (post stroke)

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2
Q

What is the difference between obstructive and central apnoeas?

A

obstructive apnoeas have associated respiratory effort whereas central apnoeas lack respiratory effort

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3
Q

What is the diagnostic criteria for OSA?

A

apnoea/hypopnea index > 5/hr + symptoms

or apnoea/hypopnea index > 15

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4
Q

What is the strongest risk factor for OSA?

A

increased BMI

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5
Q

What is the increased risk of MVA in OSA?

A

4x increased risk

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6
Q

What are the complications of OSA?

A 
HTN
IHD
CCF
AF
CVA
pulmonary HTN
DM
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7
Q

What is the most common arrhythmia in OSA?

A

nocturnal bradyarrhythmias

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8
Q

What are the elements of the STOP BANG score?

A 
snoring
tiredness
observed apnoeas 
blood pressure
BMI
age
neck circumference
gender
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9
Q

What is the sensitivity and specificity of the Epworth Sleepiness Scale for OSA?

A

low sensitivity and specificity

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10
Q

What is the best predictor of CPAP usage?

A

adherence at 2 weeks - 3 months

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11
Q

What are the benefits of CPAP?

A

improves daytime sleepiness, depression, cognitive function, QOL, systolic BP
reduces risk of MVA

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12
Q

What did the SAVE study show?

A

No RCT evidence that CPAP decreases CV mortality

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13
Q

What did the RICCADSA study show?

A

treating moderate to severe OSA in non sleepy patients with CAD did not improve CV outcomes

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14
Q

What are the features of obesity hypoventilation syndrome?

A
  1. awake hypercapnea (CO2 > 45)
  2. BMI > 30
  3. sleep disordered breathing
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15
Q

How does obesity hypoventilation syndrome usually present?

A

acute on chronic respiratory failure and/or right heart failure

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16
Q

How is leptin involved in the pathophysiology of OHS?

A

there is leptin resistance and leptin is a respiratory stimulant

17
Q

What is the treatment for OHS?

A

CPAP usually first choice if co-exisiting OSA, but if minimal/mild OSA may need NIV

18
Q

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

A

optimise heart failure therapy

19
Q

Does positive airway pressure reduce mortality in heart failure?

A

No

20
Q

What are the benefits of CPAP in OSA/heart failure?

A

improve EF
improve BP
improve exercise capacity
improve QOL

21
Q

What did the SERVE HF study show?

A

increased mortality in adaptive servo ventilation for Cheyne Stokes Respiration in heart failure

22
Q

What causes narcolepsy?

A

autoimmune destruction of hypothalamic neurones that produce hypocretin (which regulates arousal and transition between wake and sleep)

BPT Respiratory (10 decks)

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