Obstructive Sleep Apnea

Question 1

Attempts to measure how deeply you are during the day

Answer 1

Epworth sleepiness Scale

Question 2

Epworth sleppiness Scale Interpreatation

Answer 2

0-9 Normal
10-24 Excessive daytime Sleepiness
11-15 Mild to moderate sleep apnea
>16 Severe sleep apnea or narcolepsy

Question 3

Additional question for OSA (Epworth Sleepiness Scale)

Answer 3

Do you snore or wake up unrefreshed?

Diabetic?

Hypertensive?

Question 4

Intermittend obstruction of the Upper airway during sleep resulting in the total absence of flow (>10secons) despite contonued respiratory effort

Answer 4

OSA

Question 5

NArrowest part of the pathway

Answer 5

oropharynx

Question 6

Snoring

Answer 6

Soft palate vibrating

Question 7

Main function of Sleep

Answer 7

Restore body function.

Only deep sleep has restorative effect

Question 8

What triggers sleep?

Answer 8

Interplay between external and internal triggers

Question 9

Sleep center

Answer 9

Suprachiasmatic nucleus in the midbrain

Question 10

Average duration of Sleep

Answer 10

Children: 15 hours
Elderly : 3-4 hours

Average : 6-8 hours

Question 11

Used to evaluate phases of sleep using pattern recognition to determine REM and NREM sleep

Answer 11

EEG

Question 12

N1

Answer 12

Onset of sleep
Lightest Stage of Sleep
Easily aroused
Non-restorative

Question 13

N2

Answer 13

Light/shallow sleep
Decrease in heart rate
Decrease in temperature
Non restorative

Question 14

N3

Answer 14

Deep sleep/ Slow wave sleep
brain waves slow down
Difficult to wake up
If the patient does wake up from N3 (Disoriented)

Question 15

REM

Answer 15

Very deep sleep
Dreams
Eyes are moving 
Dissociation with brain and muscle activity
Phase where body is restored

Question 16

EEG in REM

Answer 16

Similar to that of awake person

Question 17

Sleep Cycle

Answer 17

Divided approximately every 90 minutes

Question 18

1st cycle of Sleep cycle

Answer 18

lasts about 120 minutes

Question 19

With each succeeding cycle,

Answer 19

NREM duration decreases while REM duration increases

Question 20

Sleep becomes deeper as it ______

Answer 20

lengthens

Question 21

Deepest sleep occur during??

Answer 21

Morning

Question 22

total sleep time

Answer 22

Children: 9 hours/day, >500 min/day

Elderly: about 6-7 hours, about 360 min/day

Question 23

SWS (slow wave sleep/ S3 and S4) is _________

Answer 23

greatly decreased as one ages

Question 24

Most common dominant phase in sleep

Answer 24

S2

Question 25

Time when you lie down to the time you go to sleep

Answer 25

Sleep latency

Question 26

Pattern of sleep urge

Answer 26

bimodal pattern

Question 27

Excessive daytime sleepiness

Answer 27

OSA syndrome

Question 28

Cessation of breathing

Answer 28

OSA

Question 29

Includes cardiovascular disease, diabets, OSA

Answer 29

Metabolic Syndrome

Question 30

Type of malocclusion which refers to an abnormal posterior positioning of the maxilla or mandible, particularly the mandible, relative to the facial skeleton and soft tissues; a retrognathic mandible is coomonly referred to as overbite)

Answer 30

Retrognathia

Question 31

Gold standard for diagnosing OSA

Answer 31

Polysomnograph

Question 32

Polysomnograph

Answer 32

Measures number of hypopnea and obstructive apnea

Body wakes up if an obstruction occurs for >10 seconds

Question 33

Apnea-Hypopnea Indes (AHI)

Answer 33

> 5 obstructions/hr = OSA

>30 obstructions in an hour = severe OSA

Question 34

Done after definitive diagnosis

Answer 34

CPAP titration studies

Question 35

CPAP

Answer 35

cure rate - 95-100%
Gold standard for treatment
Mechanical splint to open up the airway