Chapter 8 - OSA - Exam 2

Question 1

what is obstructive sleep apnea

Answer 1

characterized by partial or complete upper airway obstruction during sleep

recurrent and repetitive upper airway obstruction
reduced ventilation or apnea during sleep

Question 2

pathology of osa

Answer 2

airflow obstruction occurs because
1. narrowing of the air passages with relaxation of muscle tone during sleep and/or
2. the tongue and soft palate falling backward and partially or completely obstruct the pharynx

Question 3

how long can obstruction of airway last during osa

Answer 3

10 to 90 seconds

Question 4

what happens during the apnea period in osa

Answer 4

hypoxemia and hypercapnia

Question 5

what is hypoxemia

Answer 5

decreased PaO2 or SpO2 in blood

Question 6

what is hypercapnia

Answer 6

increased PaCO2

Question 7

these changes in O2 or CO2 cause what action to happen

Answer 7

stimulates ventilation and cause brief arousals. arousals are often under the threshold of awakening, therefore patients might not remember apnea the next day

Question 8

what happens when the patient is aroused after apnea

Answer 8

patient resumes regular ventilation with a startle response, this includes snorts and gasps which causes the tongue to move forward and the airway to open

Question 9

apnea and arousal cycles occur _________through out the night

Answer 9

repeatedly

Question 10

what is the single cause for OSA

Answer 10

trick question there is no single cause, there are multiple factors that infuence airway patency and airway muscle tone

Question 11

what are risk factors for osa

Answer 11

obesity, 65+ age, neck circumfrance >16 inches, male, postmenopausal women

Question 12

what are the 3 S’s

Answer 12

snoring, sleepiness, and spouse

Question 13

treatment of osa

Answer 13

weight loss, cpap, bipap, avoid ETOH

tonsillectomy or uvulopalatopharyngoplasty, or nasal septoplasty.

life threatening patient may need tracheostomy

Question 14

how is osa clinically diagnoised

Answer 14

sleep study, home study

Question 15

severe apnea can be associate with ___ to ____ apneic event per hour of sleep

Answer 15

30 to 50

Question 16

_____ therapy can be effective by reducing gravity’s effect on the airyway

Answer 16

positional

Question 17

teach patient to avoid ______ or drinking ________ 3 to 4 hours before sleep

Answer 17

sedatives, alcoholic

Question 18

teach the patient the dangers of ______ or using heavy equipment due to profound sleepiness

Answer 18

driving

Question 19

_________ is common for people with osa

Answer 19

insomnia

Question 20

the diagnosis of sleep apnea is based on calculation of the ___________ index

Answer 20

apnea-hypopnea.

this is an hourly average of apneic events of hypopneas of at least 10 seconds duration

Question 21

osa is defined as an AHI greater than ____ events per hour with a 3-4% decrease in oxygen saturation

Answer 21

5

Question 22

tools used to screen for osa are the Berlin and teh ______ _______ questionaiares

Answer 22

STOP BANG

Question 23

how does a cpap work

Answer 23

cpap “continuous postive airway pressure”

patient applies a nasal or oral-nasal mask that is attached to a blower,
the blower is adjusted to maintain enough positive pressure in the airway during inspiration and expiration to prevent airway collapse

Question 24

when patients with a history of osa are hospitilized, be aware that giving wht may worsen OSA symptoms

Answer 24

opioid analgesics and sedating medications that cause respiratory depression

Question 25

for patient with mild osa, _____ appliances may be preferable to positive airway pressure

Answer 25

oral

Question 26

oral appliances bring the mandible and tongue _____ to enlarge airway

Answer 26

forward

Question 27

patients using cpap may report _________ as a problem using it

Answer 27

nasal stuffiness

Question 29

which condition involves a brings and sudden loss of skeletal muscle tone or weakness

Answer 29

cataplexy

Question 30

which method is used to diagnose insomnia

Answer 30

self report

Question 31

which patient finding is a risk factor for sleep apena?
a. age 44
b. bmi 32 kg
c. neck circumference 18 inches
d. occasional consumption of alcohol
e.postmenopausal women

Answer 31

b,c,e