OSA - waldron

Question 1

What is obstructive sleep apnea

Answer 1

characterized by episodes of complete airway collapse or partial collapse with associated decrease in oxygen saturation or arousal from sleep

Question 2

What does OSA have significant implications for

Answer 2

cardiovascular health, mental illness, quality of life and driving safety

Question 3

what are the symptoms of OSA

Answer 3

loud, disruptive snoring, witnessed apneas during sleep, and excessive daytime sleepiness

Question 4

what is the most common cause of OSA in children

Answer 4

enlarged tonsils and/or adenoids

Question 5

what is the most common cause of OSA in adults

Answer 5

obesity
males
advancing age

Question 6

what is apnea caused by

Answer 6

at least 90% anterior to posterior collapse of the airway > 10 seconds

Question 7

what is hypopnea characterized by

Answer 7

at least 30% reduction in airflow > 10 seconds associated with oxygen desaturation or arousal on EEG

Question 8

what is the epworth sleepiness scale

Answer 8

indicator of inadequate restorative nighttime sleep
score range 0-24: >10 suggestive of sleep disorder rather than generalized fatigue

Question 9

what is the berlin questionnaire

Answer 9

predicts high or low likelihood OSA
loudness and frequency of snoring
apnea epsiodes
daytime sleepiness
HTN
obesity

Question 10

What is the STOP-BANG score

Answer 10

most specific to OSA - clinical presentation
3 or more + answers consider them higher risk of OSA
Snoring, Tired, Observed apnea, Pressure, BMI more than 35, A older than 50 yo, Neck greater than 40cm, Gender (male)

Question 11

what is the gold standard diagnosis for OSA

Answer 11

nighttime in-labratory polysomnography (PSG)

Question 12

what is monitored on PSG

Answer 12

EEG leads
pulse ox
temp and pressure sensors to detect nasal and oral airflow
respiratory impedance plethysmography: motion of chest and abdomen
ECG lead
EMG sensor to detect muscle contraction in chin, chest and legs

Question 13

What is a HST

Answer 13

home sleep test
higher accessibility and lower cost
monitors pulse ox, HR, temp and pressure sensors, resistance belts around chest/abdomen to detect motion, body position sensor

Question 14

what is AHI

Answer 14

Apnea -hypopnea index: average number of obstructive events

Question 15

what is diagnostic of OSA with AHI in adults

Answer 15

> 15 events/hour

Question 16

what is mild, moderate and severe AHI in children with OSA

Answer 16

Mild: 1-4.9 events/hour and clinical sequelae
Mod: 5-9.9 events/hour
Severe: 10+/hour

Question 17

What is CPAP

Answer 17

continuous positive airway pressure: most effective treatment of OSA

Question 18

what is the primary treatment for child OSA

Answer 18

tonsillectomy and adenoidectomy

Question 19

What are the surgical options for OSA

Answer 19

Uvulopalatoparyngoplasty (UPPP)
Drug-Induced sleep endoscopy (DISE)
Maxillomandibular advancement (MMA)