Sleep Disorders Flashcards Preview

MD2 Surgery and Anaesthesia > Sleep Disorders > Flashcards

Flashcards in Sleep Disorders Deck (24):
1

What is restless leg syndrome?

Idiopathic
- Affects younger people
- At rest
- Feels like electricity going through legs
Secondary
- Most common in lumbosacral disease
- Burning sensation in legs
- Happens later on in night

2

What are the changes in respiratory control at sleep onset?

Loss of wakeful drive to breathe and behavioural influences
Down-regulation of
- Respiratory reflexes
- Chemosensitivity
- Upper airway and respiratory pump muscle tone

3

What are the cardinal symptoms of sleep apnoea?

Heavy snoring
Excessive daytime somnolence
Witnessed apnoea

4

What are other nocturnal symptoms of sleep apnoea?

Disrupted/restless/un-refreshed sleep
Nocturnal choking and/or gasping
Nocturia

5

What are the daytime symptoms of sleep apnoea?

Headaches
Memory/cognitive/concentration deficit
Mood change
- Depression
- Irritability
Sexual dysfunction
- Decreased libido
- Impotence

6

What is the most common cause of secondary hypertension?

Obstructive sleep apnoea

7

What are the risk factors for obstructive sleep apnoea?

Age
Male
Obesity
Alcohol/sedatives
Upper airway morphology, including nasal obstruction

8

How is obstructive sleep apnoea diagnosed?

Full polysomnography
>5 events/hour

9

How is apnoea defined when obstructive sleep apnoea is diagnosed?

Complete cessation of airflow for 10 sec/longer, regardless of O2 desaturation

10

How is hypopnoea defined when obstructive sleep apnoea is diagnosed?

30+% reduction in airflow associated with 3% O2 desaturation/alpha wave arousal from sleep

11

What is the management for obstructive sleep apnoea?

Conservative treatment
CPAP
Oral appliances
Surgery - major facial reconstruction

12

What is conservative treatment for obstructive sleep apnoea?

Weight loss
Avoid
- Alcohol
- Tobacco
- Sedatives
Sleep on side
Treat nasal congestion
Treat medical disorders; eg: hypothyroidism

13

When is the use of oral appliances for the treatment of obstructive sleep apnoea indicated?

Snoring
Mild-moderate disease
Failed CPAP treatment

14

What are the contraindications for the use of oral appliances in the treatment of obstructive sleep apnoea?

Dentures/lack of teeth
Periodontal problems
TMJ disorder
Severe nasal obstruction
Severe hypoxia

15

What problems can oral appliances cause?

Excessive salivation
Discomfort in teeth and jaw
Movement of teeth
TMJ dysfunction

16

What is central sleep apnoea?

Apnoeas/hypopnoeas caused by reduction in central respiratory drive

17

What are the causes of central sleep apnoea?

Cardia failure > Cheyne-Stokes respiration
High altitude
CNS disorders
Idiopathic

18

How is central sleep apnoea due to heart failure managed?

Treat heart failure
CPAP
?O2

19

How is idiopathic central sleep apnoea treated?

?O2
?Non-invasive ventilation

20

What is chronic insomnia?

Subjective dissatisfaction with sleep quality/duration
Difficulty falling asleep at bedtime
Waking up in middle of night/too early in morning
Non-restorative/poor quality sleep
Associated daytime symptoms
Functional impairments

21

What disorders can contribute to insomnia?

Obstructive sleep apnoea
Circadian disorders
Restless legs
Psychiatric disorders
Substance abuse
Pain
Urinary problems
Medications

22

What are some treatment strategies for insomnia?

Treat comorbid disorders
Stimulus control therapy
Sleep restriction
Relaxation
Biofeedback
Paradoxical intention
Sleep hygiene
Short-term hypnotics

23

What are pharmacological options for the treatment of insomnia?

Benzodiazepines
Non-benzodiazepines
Others; eg: antidepressants

24

What is narcolepsy?

Disorder of sleep regulation
Deficiency in neurotransmitter orexin
Autosomal dominant with incomplete penetrance