Sleep Related Breathing Disorders Flashcards
What effects the quality of sleep a person gets?
The number of arousals per night
What is the average sleep cycle length?
90-110 minutes
repeated 3-6 times per night
REM and Non-REM sleep
What are the different classifications of Sleep disorders?
Insomnia Sleep disordered breathing Parainsomnias Hyperinsomnias Circadian rhythm disorders Movement disorders
What are the respiration factors that change during Sleep?
Airway resistance increases by 230% during NREM sleep
Tidal volume decreased
Minute ventilation is decreased
What causes Obstructive sleep apnea?
Dynamic upper airway narrowing or closure during sleep
Combo of:
dec muscular tone during sleep
Crowding of upper airway structures
What is the Triad of OSA?
Loud Snoring
O2 Desaturations
Frequent arousals
What are the Risk factors for OSA?
Obesity (BMI >35) Family History Retro gnathia Treatment resistant HTN CHF, atrial fibrillation, stroke T2 DM
Who should be screened for OSA?
Pt that are dissatisfied with their sleep/have daytime sleepiness
Pts with Risk factors
Pts with high risk driving occupations or daytime sleepiness + MVA
What are the important factors to look at in PE in OSA?
BMI Neck >16 in women, >17 in Men Macroglossia Enlarged or elongated uvula Nasal obstruction Retrognathia
What qualifies Polysonography in OSA?
Event if Apnea for >10 sec
(look at the thoracic/abdominal belt)
Apnea = Decrease in AF by >50%
Hypopnea = dec in AF by 30% AND drop in Pulse Ox by 4%
AHI = Apnnia Hypopnea Index (number of apneas and hypopneas per hour of sleep)
What are the specific managements of OSA?
CPAP (Continuous Positive Airway Pressure) Oral appliances Maxillo mandibular advancement Uvulo/palatopharyngoplasty Tonsilectomy, nasal septostomy Tracheostomy
What is CSA(central sleep apnea)?
Recurrent Cessation of Respiration during sleep without associated ventilatory effort
How is CSA Classified?
Primary central sleep apnea Cheyne-stokes breathing-central sleep apnea High altitude periodic breathing CSA due to other medical conditions CSA due to drugs or substances
