Sleep related breathing disorders

Question 1

what must occur for sleep to be restorative?

Answer 1

all stages must be achieved

Question 2

delta waves are important for what brain process?

Answer 2

learning and memory

Question 3

complete lack of muscle tone characterizes what sleep stage?

Answer 3

REM

Question 4

how long is the sleep cycle length?

Answer 4

90-110 minutes

Question 5

what are the respiratory functions during sleep?

Answer 5

tidal volume DOWN
airway resistance INCREASES (NREM)
increase in PaCO2 2-4 mm Hg
decrease in PaO2 by 3-9 mm Hg

Question 6

what are the sleep related breathing disorders (3)?

Answer 6

obstructive sleep apnea syndrome
central sleep apnea syndrome
sleep related hypoventilation syndrome

Question 7

what is the physiopathology of obstructive sleep apnea?

Answer 7

1. dynamic upper airway narrowing or closure during sleep

2. combination of decreased muscular tone and crowding of upper airway structures

Question 8

definition: obstructive sleep apnea syndrome

Answer 8

recurrent episodes of partial or complete upper airway obstruction during sleep that usually are terminated by an arousal

Question 9

what is the triad for obstructive sleep apnea syndrome?

Answer 9

loud snoring
oxygen desaturations
frequent arousals

Question 10

what are the screening tools for obstructive sleep apnea syndrome?

Answer 10

berlin questionnaire

STOP-BANG screening test

Question 11

what is the most common cause of sleep apnea in children?

Answer 11

enlarged tonsils

Question 12

what is the standard measures for diagnosing and determining severity of OSA?

Answer 12

polysomnography

Question 13

a sleep study event has to last how long in order to be “counted”?

Answer 13

10 seconds

Question 14

definition: epoch

Answer 14

30 seconds

Question 15

sleep study definition: apnea

Answer 15

decrease in airflow by over 50%

Question 16

sleep study definition: hypopnea

Answer 16

decrease in airflow by 30% AND drop in pulse ox by 4%

Question 17

sleep study definition: AHI

Answer 17

apnea hypopnea index - number of apneas and hypopneas per hour of sleep

Question 18

what is the gold standard for OSA management?

Answer 18

CPAP - continuous positive airway pressure therapy

Question 19

CPAP therapy may modify or prevent outcomes in what other conditions?

Answer 19

HTN
EF in CHF
Af

Question 20

definition: central sleep apnea (CSA)

Answer 20

recurrent cessation of respiration during sleep without associated ventilatory effort

Question 21

what is the pathophysiology of CSA?

Answer 21

high ventilatory chemo responsiveness to paCO2 with exaggerated hyperpnea and subsequent decrements of paCO2 below patient’s apneic threshold and perpetuation of pattern

Question 22

cheyne stokes is indicative of what type of sleep apnea?

Answer 22

CSA

Question 23

what is the primary sleep related hypoventilation syndrome?

Answer 23

congenital central alveolar hypoventilation

Question 24

what are the secondary sleep related hypoventilation syndromes? how are they diagnosed?

Answer 24

obesity hypoventilation syndrome
severe pulmonary diseases
neuromuscular or skeletal abnormalities

PSG, ABG