Sleep Apnoea and Neuromuscular Respiratory Disorders

Question 1

What does OSAS stand for?

Answer 1

Obstructive sleep apnoea syndrome

Question 2

Define nacrolepsy

Answer 2

A condition characterized by an extreme tendency to fall asleep whenever in relaxing surroundings.

Question 3

What is often a comon feature of patients suffering from narcolepsy?

Answer 3

Cataplexy - a medical condition in which strong emotion or laughter causes a person to suffer sudden physical collapse though remaining conscious.

Question 4

What is primary snoring?

Answer 4

–snoring without apnea, hypoventilation, hypoxia, hypercapnea, daytime symptoms

Question 5

What can primary snoring progress to?

Answer 5

OSAS

Question 6

When is OSAS most common?

Answer 6

Pre-school child

Question 7

What is the prevalence of OSAS?

Answer 7

2%

Question 8

What are the associated morbidities with sleep apnoea?

Answer 8

Failure to thrive

Neurocognitive defects/adhd

Systemic hypertension

Cor Pulmonale

Question 9

What is the difference between Adult versus Childhood OSAS?

Answer 9

Question 10

What is the treatment for OSAS?

Answer 10

Adenotonsillectomy

CPAP - (Continuous positive airway pressure therapy (CPAP ) uses a machine to help a person who has obstructive sleep apnea (OSA) breathe more easily during sleep. ACPAP machine increases air pressure in your throat so that your airway doesn’t collapse when you breathe in)

Weight loss

Avoid environmental tobacco smoke

Question 11

What are the respiratory disorders associated with sleep apnoea?

Answer 11

Chronic neonatal lung disease

–hypoxaemia in REM sleep (similar COPD)

–cardiac complications

Cystic Fibrosis

–FEV1 30-60% associated with decrease SaO2 (~8%)

–less REM/more awakenings

Asthma

Question 12

What neuorlogical disorders are associated with sleep disorders?

Answer 12

Cerebral palsy

–fragmented sleep/delayed onset

–melatonin

Down Syndrome

–OSAS

Prader-Willi Syndrome

–excessive daytime sleepiness

•Neuromuscular disease (Duchenne’s MD)

–death due to respiratory failure

–nocturnal desaturation associated with FVC <1litre

–increasing quality of life/survival with BiPAP - Bilevel Positive Airway Pressure

Question 13

What are the three types of sleep apnoea?

Answer 13

Obstructive sleep apnoea - caused by blockage in the upper airway

Central sleep apnea - brain fails to signal the muscles to breathe

Mixed apnoea - combination of above

Question 14

Which type of sleep apnea is most common in infants and premature babies?

Answer 14

Central sleep apnea

Question 15

Who often has mixed apnea?

Answer 15

SMaller premature babies

Question 16

Who is most likely to have OSA?

Answer 16

Adults and children age 1 year and older

Question 17

Why do children with Down Syndrome have a higher incidence of sleep apnea?

Answer 17

Condition affects the upper airway

Question 18

In babies, what are the common causes of sleep apnea?

Answer 18

Immaturity of the brain stem - regulates breathing

Upper airway Obstruction

Question 19

What are the other common causes of sleep apnea?

Answer 19

Bleeding in the brain

Exposure to drugs or poisons

Birth defect

INfection

Respiratory disaese

Gastrointestinal problems (like reflux)

Imbalance in body chemistry (incorrect amounts ofcalcium or glucose)

Problems with the heart or blood vessels

Question 20

What is meant by periodic breathing?

Answer 20

An irregular breathing pattern

Typically starts with rapid breaths, then slower breaths, then a pause in breathing for five to 10 seconds. Then the pattern resumes with rapid breaths, and so on. Periodic breathing isn’t anything to worry about, and babies usually outgrow it by the time they’re about 6 months)

Question 21

What are the symptoms of sleep apnea?

Answer 21

Some babies with sleep apnea stop breathing for 20 seconds or longer during sleep. Others stop breathing for shorter periods and become limp, turn pale or blue, or have a slowed heart rate as they sleep.

Question 22

What is the test often used to diagnose sleep apnea?

Answer 22

Polysomnogram

Question 23

What does polysomnogram consist of?

Answer 23

Procedure performed in a sleep lab.

Monitors brain waves, eye movements, breathing and oxygen level as well as snoring and gasping sounds.

Question 24

What is sleeplessness caused by?

Answer 24

Behavioural problems

Medication

Neurological Disorders (melatonin)

Question 25

Why are people who are narcoleptic often obese?

Answer 25

Narcolepsy can be caused by Orexin deficiency. Orexin is responsible for stimulating food intake, stimulates wakefulness, regulates energy expenditure, and modulates visceral function.

Orexin is needed for brown preadipocytes to differentiate into brown adipose tissue. Brown adipose tissue is responsible for thermogenesis. Therefore impaired thermogenesis and reduced energy expenditure.