Sleep Disorders Highlights Flashcards
Define:
1) Apnea
2) Hypopnea
3) Mixed apnea
1) Apnea – cessation of breathing for at least 10 seconds
Hypopnea – decrement in airflow with drop in O2Sat% of at least 4%
3) Mixed apnea = absent effort precedes upper airway obstruction during the apneic spell
Sleep-related breathing disorders
Central apnea = ventilation effort absent for duration of apneic spell
Obstructive apnea = ventilatory effort persists throughout the apneic spell transient obstruction of the upper airway
List 3 important risk factors for OSA
1) Obesity – especially neck
2) Sex (male)
3) Age over 40, but can affect any age
List the 3 cardinal Sx for OSA
Snoring
Nonrestorative sleep
Excessive daytime sleepiness
Explain STOP-BANG
Snore
Tired
Observed apnea
Pressure (HTN)
BMI > 35
Age > 50
Neck > 40 CM
Gender - male
In patients with a pre-test probability of moderate to severe OSA, what is the confirming test?
Polysomnography (sleep study)
What is AHI (Apnea-hypopnea index)?
Number of apneas and hypopneas per hour
How do you interpret AHI?
5-14 = mild OSA
15-30 = moderate OSA
>30 = severe OSA
AHI:
1) What score diagnoses OSA?
2) When may CPAP be indicated?
1) AHI 5+/hour
2) If AHI 15+
American Academy of Sleep Medicine says:
Clinical tools, questionnaires and prediction algorithms __[should/ should not]___ be used to diagnose OSA in adults in the absence of ________________
should not; polysomnography
What should be used for the diagnosis of OSA is patients with S/S of OSA?
Polysomnography, or home sleep testing
What can Tx OSA?
Positive Airway Pressure device
What medical therapy is recommended for all pts with OSA?
Weight loss (factor in 70% of cases),
Give the BLUF
Ask your patients if they snore
50% of patients that snore deny it
Ask bed partner
If yes = Sleep Airway Obstruction
STOP-BANG for pre-test probability
If pre-test probability moderate or more,- sleep study to diagnose
AHI > 15 – trial of PAP
AHI of 5 or more + comorbid – trial of PAP
