Sleep related breathing disorders Flashcards
what must occur for sleep to be restorative?
all stages must be achieved
delta waves are important for what brain process?
learning and memory
complete lack of muscle tone characterizes what sleep stage?
REM
how long is the sleep cycle length?
90-110 minutes
what are the respiratory functions during sleep?
tidal volume DOWN
airway resistance INCREASES (NREM)
increase in PaCO2 2-4 mm Hg
decrease in PaO2 by 3-9 mm Hg
what are the sleep related breathing disorders (3)?
obstructive sleep apnea syndrome
central sleep apnea syndrome
sleep related hypoventilation syndrome
what is the physiopathology of obstructive sleep apnea?
- dynamic upper airway narrowing or closure during sleep
2. combination of decreased muscular tone and crowding of upper airway structures
definition: obstructive sleep apnea syndrome
recurrent episodes of partial or complete upper airway obstruction during sleep that usually are terminated by an arousal
what is the triad for obstructive sleep apnea syndrome?
loud snoring
oxygen desaturations
frequent arousals
what are the screening tools for obstructive sleep apnea syndrome?
berlin questionnaire
STOP-BANG screening test
what is the most common cause of sleep apnea in children?
enlarged tonsils
what is the standard measures for diagnosing and determining severity of OSA?
polysomnography
a sleep study event has to last how long in order to be “counted”?
10 seconds
definition: epoch
30 seconds
sleep study definition: apnea
decrease in airflow by over 50%
sleep study definition: hypopnea
decrease in airflow by 30% AND drop in pulse ox by 4%
sleep study definition: AHI
apnea hypopnea index - number of apneas and hypopneas per hour of sleep
what is the gold standard for OSA management?
CPAP - continuous positive airway pressure therapy
CPAP therapy may modify or prevent outcomes in what other conditions?
HTN
EF in CHF
Af
definition: central sleep apnea (CSA)
recurrent cessation of respiration during sleep without associated ventilatory effort
what is the pathophysiology of CSA?
high ventilatory chemo responsiveness to paCO2 with exaggerated hyperpnea and subsequent decrements of paCO2 below patient’s apneic threshold and perpetuation of pattern
cheyne stokes is indicative of what type of sleep apnea?
CSA
what is the primary sleep related hypoventilation syndrome?
congenital central alveolar hypoventilation
what are the secondary sleep related hypoventilation syndromes? how are they diagnosed?
obesity hypoventilation syndrome
severe pulmonary diseases
neuromuscular or skeletal abnormalities
PSG, ABG
