Sleep Related Breathing Disorders Flashcards Preview

Respiratory > Sleep Related Breathing Disorders > Flashcards

Flashcards in Sleep Related Breathing Disorders Deck (53):
1

What is the sleep requirements for neonates? Adults?

12-18 hours
7-9 hours

2

What is the level of caffeine intake that is safe for adults?

400 mg

3

How many sleep disturbances per hour can affect performance?

5 times/hour

4

What are the waves that are found in deep sleep?

Delta waves

5

What is the length of the sleep cycle? How many times are cycles repeated each night?

90-110 minutes

3-6 cycles per night

6

What are the two general stages of sleep?

Non-REM
REM

7

What is a hypnogram?

A recording of the sleep cycle

8

What are the four major effects of sleep deprivation?

-excessive daytime sleepiness
-Irritability/anxiety
-Decreased performance
-HTN, insulin resistance

9

What percent of adults have complaints of sleep disruption?

30%

10

What is the most common sleep disorder?

insomnia

11

What happens to Vt with sleep?

Reduced by 6-16% during NREM and 25% in REM

12

What happens to airway resistance with sleep? Why?

Increases by 230% during NREM

Reduced tonic drive to the pharyngeal muscles

13

What is the effect of the reduction of ventilation with sleep?

increases PaCO2 by 2-4 mmHg, and reduces PaO2 by 3-9 mmHg

14

What are the three major sleep related breathing disorders?

-Obstructive sleep apnea
-Central sleep apnea
-Sleep related hypoventilation syndrome

15

What is OSA? What are the two major physiologic causes?

Dynamic upper airway narrowing or closure during sleep d/t a combination of:
-Decreased muscular tone
-Crowding of upper airway structures

16

is snoring an upper or lower airway obstruction? When, then, does it occur in the respiratory cycle?

Upper airway
Inspiration

17

What is the triad of OSA?

-Loud snoring
-Oxygen desaturation
-Frequent arousals

18

What is the incidence of OSA in men and women?

4% and 2% respectively

19

Who should be screened for OSA?

-Dissatisfied with sleep
-Do they have daytime sleepiness

20

What are the non-obvious risk factors for OSA? (heart x2, metabolic conditions)

-HTN
-CHF
-DM II

21

What occupation in particular should be screened for OSA?

High risk driving occupations

22

What are the two questionnaires that can be administered to screen for OSA?

-Berlin questionnaire
-STOP-BANG test

23

Over what BMI is OSA particularly common?

Over 35

24

What is the most common reason for OSA in children?

Adenotonsillar hypertrophy

25

What is the scale used to determine the severity of sleepiness?

Epworth sleepiness scale

26

What type of work specifically can lead to excessive daytime sleepiness?

Shift work

27

What are the components of the PE that should be done if you suspect OSA?

-Respiratory
-Neck
-Mallampati score

28

A mallampati score of what is suspicious for OSA?

3 or 4

29

What neck circumference for men and women are concerning for OSA?

16" for females
17" for males

30

What is class I mallampati score?

Can see uvula, soft and hard palate and pillars

31

What is class II mallampati score?

Uvula touches tongue, pillars not present

32

What is class III mallampati score?

Can barely see uvula and hard palate

33

What is class IV mallampati score?

Can only see soft palate

34

How do you evaluate for OSA?

Polysomnography in the sleep lab

35

What are the two types of sleep studies?

Full night sleep
Split night sleep (before and after CPAP)

36

What is CPAP?

Continuous positive airway pressure

37

Why are EKGs needed with sleep studies?

Apnea may cause arrhythmias

38

An event on a sleep study must last how long to be considered sleep apnea?

10 seconds

39

What is the classic breathing pattern with OSA?

Paradoxical breathing

40

What is the definition of Hypopnea?

Decrease in airflow by 30% AND drop in pulse ox by 4%

41

What is apnea hypopnea index (AHI)?

Number of apnea and hypopneas per hour of sleep

42

What is the role of in-home sleep studies?

Uncomplicated patients, but does not definitively exclude diagnosis

43

Sleeping in what position may lead to an increase in sleep apnea episodes?

Supine

44

What are the therapies for OSA, besides CPAP?

Oral appliances
Maxillomandibular advancement

45

What is the last resort for sleep apnea?

Tracheostomy

46

What is "adequate" CPAP use?

more than 4 h/night on 70% of nights

47

What are the sequelae of untreated sleep apnea?

HTN
Insulin resistance

48

What is central sleep apnea (CSA)?

Recurrent cessation of respiration during sleep without associated ventilatory effort

49

What is the pathophysiology of central sleep apnea?

High ventilatory chemo responsiveness to PaCO2 with exaggerated hyperapnea

50

What is Cheyne-stokes respiration?

irregular crescendo-decrescendo pattern of breathing

51

What are the diseases associated with Cheyne stokes respiration?

CHF
Cerebrovascular disease
Renal insufficiency

52

What is the cause of Cheyne-stoke respiration?

Decreased perfusion of breathing centers of the brain (maybe)

53

What is congenital central alveolar hypoventilation?

a life-threatening disorder manifesting as sleep-associated alveolar hypoventilation