Week 5 - Sleep Apnoea and Narcolepsy Flashcards
What is sleep apnoea?
recurrent upper airway obstruction in sleep leading to temporary cessation of breathing
what is apnoea vs hypopnoea?
apnoea is obstruction for 10+ seconds. hypopnoea is obstruction for <10 seconds
How is sleep apnoea diagnosed?
detailed clinical history, epworth questionnaire, overnight sleep study
what are the 3 overnight sleep studies?
pulse oximetry
limited sleep studies
full polysomnography
What is pulse oximetry?
finger clip checking O2 sats all night
What is limited sleep studies?
pulse oximetry + strap to waist measuring thorax and abdomen movements. also checks nasal flow
What is full polysomnography?
all of limited sleep studies - also camera, audio, EEG
How is grade of sleep assessed?
apnoea hypopnoea index - total no. of apnoeas and hypopnoeas during sleep/no.of hours of sleep. more = more severe sleep apnoea
What occurs in the brain during sleep in an individual with apnoeas?
many microarousals - brain entering and leaving REM sleep. leads to dissatisfactory sleep
What are alternative treatments for sleep apnoeas?
endocrine disorders may cause sleep apnoeas. treat these first
lose fat around neck
alcohol worsens sleep apnoea and snoring
What is the main treatment
CPAP (continuous positive airways pressure) machine. creates positive airway in throat to stop tissues being sucked together . mask attached to nose
What is the alternative for CPAP?
mandibular repositioning splint. looks like gum shields, goes over teeth. pulls lower jaw forward a bit, bringing base of tongue forward to make space at back of throat
What is narcolepsy and its features?
younger age, familial. sudden sleep attacks throughout the day.
- cataplexy,
- excessive daytime sleepiness,
- sleep paralysis,
- visual hallucinations
What is the symptom cataplexy?
random collapse during day appearing to be asleep, but fully aware.
What is PSG used for in narcolepsy?
- polysomnography to confirm diagnosis.
