32. Sleep apnea Flashcards Preview

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Flashcards in 32. Sleep apnea Deck (27):
1

Sleep apnea - definition

repeated cessation of breathing > 10 seconds during sleep --> disupted sleep --> somnolence

2

sleep apnea - PaO2

normal during the day
noctural hypoxia

3

sleep apnea - complications (how)

noctural hypoxia -->
1. systemic /pulmonary hypertension
2. arrhythmias (atrial fibrillation/flutter)
3. sudden death

4

sleep apnea arrthymias

1. atrial fibrillation
2.atrial flutter

5

sleep apnea - types

1. obstructive sleep apnea
2. central sleep apnea
3. obesity hypoventilation syndrome

6

obstructive sleep apnea - respiratory system

respiratory effort against aiway obstruction

7

obstructive sleep - associated with

1. obesity
2. loud snoring

8

obstructive sleep apnea in adults caused by

1. excess parapharyngeal tissue

9

obstructive sleep apnea in children caused by

2. adenotonsillar hypertrophy

10

obstrucrive sleep apnea - treatment

1. weight loss
2. CPAP
3. Surgery

11

Central sleep apnea has ... respiratory effort

none

12

central sleep apnea due to

1. CNS injury
2. CNS toxicity
3. Opiods
4. Heart failure

13

Renal respond in hypoxia

increased EPO release --> increased erythropoiesis

14

Obesity hyperventilation syndrome - BMI

>= 30 kg /m2

15

Obestity hyperventilation syndrome - respiratory rate

decreased

16

obesity hyperventilation syndrome is also known as

Pickwickian syndrome

17

Obesity hypoventilation syndrome pathophysiology

BMI >= 30 kg / m2 --> hypoventilation (decreased RR) --> decreased PaO2 and increased PaCO2 during sleep --> increased PaCO2 DURING WALKING HOURS (retention

18

obesity hypoventilation syndrome - symptoms

1. poor sleep wuality
2.sleep apnea
3.daytime slepiness
4. Depresion
5.Headaches

19

Obesity hypoventilation syndrome- blood gases abnormalities

1. increased PaCO2 during sleep
2. decreased PaO2 during sleep
3. Increased PaCO2 during walking hours (retention)

20

• A man has daytime sleepiness; his wife attributes it to disrupted sleep from breathing pauses. His daytime PaO2 is ____ (normal/low/high).

Daytime PaO2 would be normal (this patient likely has sleep apnea)

21

• A patient is diagnosed with sleep apnea. What complications may arise from the hypoxia he experiences at night?

Arrhythmias (atrial fibrillation or flutter), systemic or pulmonic hypertension, sudden death

22

• What is the difference between central and obstructive sleep apnea?

Central apnea is due to a lack of CNS-derived respiratory effort, obstructive apnea is due to a mechanical airway obstruction

23

• An obese man complains of chronic fatigue. His wife says he is an especially loud snorer. What treatments can you offer?

Treat with weight loss, continuous positive airway pressure, surgery (this is obstructive sleep apnea)

24

• A child is diagnosed with obstructive sleep apnea. What anatomic abnormality is this associated with? Adults?

Adenotonsillar hypertrophy in children; excess parapharyngeal tissue in adults

25


• Name five conditions potentially associated with sleep apnea.

Obesity, loud snoring, pulmonary/systemic hypertension, arrhythmias, and possible sudden death

26

• An obese patient has daytime somnolence, disrupted sleep, and loud snoring. CBC shows elevated hematocrit. Why is his hematocrit high?

Increased erythropoietin and increased red blood cells (the patient likely has sleep apnea causing chronic hypoxia)

27

• An obese patient snores and has disrupted sleep during which his PaO2 is reduced and PaCO2 is increased. Diagnosis?

Obesity hypoventilation syndrome, as he retains PaCO2, which is therefore high even when he is awake