Flashcards in Sleep apnea Deck (18):
What is sleep apnea?
During sleep, gracity and muscle relaxation allows the tongue and surrounding tissues to fall back into the mouth and obstruct air flow
For non-obese and young people, OSA might be caused by this?
What are some of the causes of craniofacial morphology?
Short maxilla or mandible, retropostioned mandible, inferiorly positioned hyoid boin, long anterior face height, enlarged tongue/soft palate/ uvula, large parapharyngeal fat pads and lateral pharyngeal fat pads, small upper airway spaces
Strongest risk factor for OSA?
During sleep muscle town is ________ and airways are ___________?
decreases, especially the genioglossus, and airway diameter is decreased
Physiological effects of frequent hypoxia?
Increased sympathetic tone ( increase BP), peripheral vasoconstriction, increared HR and SBP, decreased cerebral blood flow, pulm and hear effects (decreased coronary and pulmonary artery flow
Clinical manifestations for OSA?
snoring, daytime somnolence, apneas, morining dry mouth, morning headache, irritability, depression
Physical exam findings for OSA?
Obesity, crowded upper airways, neck larger than 17" mean, 16" woman, HTN
What is the GOLD standard test for diagnosis of OSA?
overnight sleep study (polysomnography)
Information derived from sleep study?
Total sleep time, sleep efficiency (TST)/time in bed, sleep stage percentage, sleep latency (time from seel onset to particular stage of sleep)
Information derived from sleep study, more important information?
arousals (# of times patients wakes), apneas (cessation of breathing), hypopneas (reduced breathing), RERAs (respiratory effort relate arousals) smaller arousals that do no meet criteria for apnea or hypopnea
What would constitute as positive for sleep apnea?
5 or more obstructive events per hour with 1 or more risk factors or greater than 15 obstructive events per hour with no risk factors
How is OSA staged?
Mild 5-15 events, moderate 16-30 events, severe >30
Standard for treating sleep apnea?
CPAP feeds continuous positive airway pressure into the airway to prevent obstruction
This treatment delivers different levels of pressure during inspiration and expiration
Bilevel positive airway pressure (BPAP)
This treatment can be offered to individuals with mild-moderate OSA who don't wanna use CPAP? May have craniofacial abnormalities
What is central sleep apnea?
Sleep apnea that results from absences of airflow during sleep that results from lack of respiratory effort