Sleep Apnea Flashcards Preview

Bioscience II > Sleep Apnea > Flashcards

Flashcards in Sleep Apnea Deck (13)
Loading flashcards...
1
Q

What is the definition of obstructive sleep apnea?

A

cessation of airflow for >10 seconds despite continuing respiratory effort…. 5 or more times per hour of sleep… usually associated with decrease in arterial oxygen saturation (SaO2) of more than 4%; in short= >10sec, >5x/hour

2
Q

Describe the cycle that occurs during sleep apnea.

A

sleep…. decrease in upper airway tone…. obstruction occurs….. apnea followed by a decrease in PO2 and increased PCO2…. resulting in a sympathetic surge leading to arousal…. increase in upper airway tone, so normal breathing resumes

3
Q

What are complications that can occur during the periods of apnea (decreased O2, increased PCO2)?

A

systemic HTN (LVH), pulmonary HTN (RVH), arrythmias (can lead to MI)

4
Q

What classifies mild, moderate, or severe sleep apnea?

A

mild: 5-15/hr
moderate: 15-30/hour
severe: >30/hr (and/or hypoxia 20% of total sleep time)

5
Q

What is the gold standard for screening of OSA?

A

polysomnography; other screening methods= Berlin questionnaire (good for primary care), STOP-BANG (most practical screening tool)

6
Q

What are some components of the STOP BANG questionnaire?

A

snore? tired? observed by anyone (stop breathing)? pressure (HTN)? BMI >35? Age >50? neck circumference >40cm? gender male?

7
Q

What are some general symptoms of central sleep apnea?

A

fatigue, snoring, obesity

8
Q

What are the 3 forms of sleep apnea?

A

central, obstructive, and complex (mixed); obstructive represents 84% of cases…. mixed about 15%

9
Q

What is the difference in CSA, OSA, or mixed sleep apnea?

A

CSA- breathing is interrupted by a lack of respiratory effort (PCO2 falls below the apneic threshold) 20%??
OSA- breathing is interrupted by a physical block to airflow despite respiratory effort… snoring common…. so basically physical obstruction or central disruption of breathing

10
Q

What are some common types of central sleep apnea?

A

Cheyne Stokes breathing: normally more common in adults suffering from CHF (periodic breathing with recurrent episodes of apnea alternating with episodes of rapid breathing)
Idiopathic central apnea: (prevalence of afib higher in this group than any other)
Narcotic induced central apnea

11
Q

What are treatments options for CSA?

A

CPAP, oxygen, inhaled CO2, acetazolamide (aka Diamox… carbonic anhydrase inhibitor…..limited supporting evidence on use), theophylline (relaxes bronchial smooth muscle… increases HR and BP, CNS stimulant effect on medullary resp center)

12
Q

What is the incidence of OSA?

A

male to female ratio 2:1; 1:5 patients have OSA ~25%

13
Q

What is polycythemia?

A

disease state in which the proportion of blood volume that is occupied by RBCs increases…. overproduction of RBCs can be d\t a primary process in the bone marrow or it can be a reaction to chronically low oxygen levels