Sleep Apnea

Question 1

the more common Disorder, causes daytime sleepiness, impairs daily function, and is amajor contributor to cardiovascular disease in adults and to behavioralproblems in children.

Answer 1

OSAHS

Question 2

Diagnosis requires the patient to have (1) either symptoms of nocturnal breathing disturbances (snoring, snorting, gasping, or breathing pauses during sleep)or daytime sleepiness or fatigue that occurs despite sufficient opportunities to sleep and is unexplained by other medical problems; and(2) five or more episodes of obstructive apnea or hypopnea per hourof sleep

Answer 2

OSAHS

Question 3

calculated as the number of episodes divided by the number of hours of sleep

episodes of obstructive apnea or hypopnea per hour of sleep

Answer 3

the apnea-hypopnea index [AHI]

Question 4

OSAHS also may be diagnosed in the absence of symptoms if the AHI is

Answer 4

> 15 episodes/h

Question 5

Each episode of apnea or hypopnea represents a reduction in breathing for at least 10 s and commonly results in a how many % drop in oxygen saturation and/or a brain cortical arousal

Answer 5

≥3%

Question 6

OSAHS maybe most severe duringthis stage of sleep (rapid eye movement) sleep, when neuromuscular output to the skeletal muscles is particularly low, and in the supine position due to gravitational forces

Answer 6

REM

Question 7

The airway may collapse at different sites, such as the

Answer 7

soft palate (most common),
tongue base
lateral pharyngeal walls
epiglottis

Question 8

airway patency is dependent on the stabilizing influence of the

Answer 8

pharyngeal dilator muscles.

Question 9

True or false:

increasing levels of CO2 during sleep result in central nervous system arousal, causing The individual to move from a deeper to a lighter level of sleep or-to awaken

Answer 9

True

Question 10

Two major risk factors of OSAHS

Answer 10

Obesity

MALE SEX

Question 11

What risk factor cause >/=4x risk for OSAHS with 10% weight gain causing more than 30% increase in AHI

Answer 11

obesity

Question 12

True or false

There is an INCREASED OSAHS prevalence in women after MENOPAUSE

Answer 12

True

Question 13

Genetic predisposition in OSAHS is _x in first degree relatives

Answer 13

2x increased

Question 14

What is the most common complaint is OSAHS

Answer 14

SNORING

Question 15

What DISTINGUISHES OSAHS from paroxysmal nocturnal dyspnea , nocturnal asthma and GERD

Answer 15

DYSPNEA

Question 16

Most common daytime symptoms in OSAHS

Answer 16

Excessive sleepiness

Question 17

What is the GOLD STANDARD for diagnosis of OSAHS

Answer 17

Overnight POLYSOMNOGRAM PSG

Question 18

is the standard medical therapy with the highest levelof evidence for efficacy.

Answer 18

CPAP

Question 19

(removal of the uvula and the margin of the soft palate) is the mostcommon surgery and, although results vary greatly, is generallyless successful than treatment with oral appliances.

Answer 19

Uvulopalatopharyngoplasty

Question 20

is often caused by an increased sensitivityto pCO2, which leads to an unstable breathing pattern that manifests as hyperventilation alternating with apnea

Answer 20

CSA central sleep apnea

Question 21

individuals with congestive heart failure are at risk for CSA. With prolonged circulation delay, there is a crescendo-decrescendo breathing pattern known as

Answer 21

Cheyne-Stokes respiration

Question 22

Cessation of airflow for >or=10seconds during sleep

Answer 22

Apnea

Question 23

Cessation of airflow for >or=10seconds during sleep accompanied by persistent respiratory effort

Answer 23

Obstructive apneas

Question 24

Cessation of airflow for >or=10seconds during sleep accompanied by absence of respiratory effort

Answer 24

Central apneas

Question 25

More than or equal 30% reduction in airflow for at least 10 secs during sleep that is accompanied by either >/= 3% desaturation or an arousal

Answer 25

Hypopnea

Question 26

A partially obstructed breath that does not meet the criteria for hypopnea but provides evidence of increasing inspiratory effort (usually thru pleural pressure monitoring) punctuated by arousal

Answer 26

RERA Respiratory effort related arousal

Question 27

Partially obstructed breath , typically within a hypopnea or RERA, identified by a flattened or “scooped out” inspiratory flow shape

Answer 27

Flow limited breath