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Pulmonology 2 > Sleep Related Breathing Disorders > Flashcards

Flashcards in Sleep Related Breathing Disorders Deck (13):
1

What effects the quality of sleep a person gets?

The number of arousals per night

2

What is the average sleep cycle length?

90-110 minutes
repeated 3-6 times per night
REM and Non-REM sleep

3

What are the different classifications of Sleep disorders?

Insomnia
Sleep disordered breathing
Parainsomnias
Hyperinsomnias
Circadian rhythm disorders
Movement disorders

4

What are the respiration factors that change during Sleep?

Airway resistance increases by 230% during NREM sleep
Tidal volume decreased
Minute ventilation is decreased

5

What causes Obstructive sleep apnea?

Dynamic upper airway narrowing or closure during sleep
Combo of:
dec muscular tone during sleep
Crowding of upper airway structures

6

What is the Triad of OSA?

Loud Snoring
O2 Desaturations
Frequent arousals

7

What are the Risk factors for OSA?

Obesity (BMI >35)
Family History
Retro gnathia
Treatment resistant HTN
CHF, atrial fibrillation, stroke
T2 DM

8

Who should be screened for OSA?

Pt that are dissatisfied with their sleep/have daytime sleepiness
Pts with Risk factors
Pts with high risk driving occupations or daytime sleepiness + MVA

9

What are the important factors to look at in PE in OSA?

BMI
Neck >16 in women, >17 in Men
Macroglossia
Enlarged or elongated uvula
Nasal obstruction
Retrognathia

10

What qualifies Polysonography in OSA?

Event if Apnea for >10 sec
(look at the thoracic/abdominal belt)
Apnea = Decrease in AF by >50%
Hypopnea = dec in AF by 30% AND drop in Pulse Ox by 4%
AHI = Apnnia Hypopnea Index (number of apneas and hypopneas per hour of sleep)

11

What are the specific managements of OSA?

CPAP (Continuous Positive Airway Pressure)
Oral appliances
Maxillo mandibular advancement
Uvulo/palatopharyngoplasty
Tonsilectomy, nasal septostomy
Tracheostomy

12

What is CSA(central sleep apnea)?

Recurrent Cessation of Respiration during sleep without associated ventilatory effort

13

How is CSA Classified?

Primary central sleep apnea
Cheyne-stokes breathing-central sleep apnea
High altitude periodic breathing
CSA due to other medical conditions
CSA due to drugs or substances