Week 1: Comfort-Sleep Flashcards
Describe Central Sleep Apnea.
- Decreased drive to breath during sleep
- Diminished or absent respiratory effort
- Neurologic Disease
Explain the pathophysiology of CSA.
- Cyclical hypernea during sleep leads to hypocapnia
- Neuromuscular or chest wall disease
- Cheyne-Strokes Breathing Pattern
- Altitude Changes
- Opioid Use
What are the 8 risk factors for CSA and what are 3 complications?
Risk Factors:
- Male
- Over 65
- Comorbid disease
- History of stroke
- Brain tumor
- High altitude
- Extended opioid use
- Fatigue
Complications:
- daytime sleepiness
- CVD
- Cardiac dysrhythmias
What are 7 manifestations of CSA?
- Periods of alternating shallow and deep breathing
- witnessed apnea
- nocturia
- poor memory
- poor concentration
- snoring
- difficulty staying awake
What are 3 tests that may be ordered to investigate CSA?
- ABGs
- BMP
- Polysomnogram
What are 4 nonpharmacologic treatments for CSA?
- Healthy diet
- Management of causes
- Decreased opioid use
- Phrenic nerve stimulation
What are 3 pharmacologic treatments of CSA?
- CPAP or BIPAP
- Supplemental Oxygen when sleeping
- Acetazolamide to stimulate breathing
Describe Obstructive Sleep Apnea.
- Upper airway closes and becomes obstructed during sleep.
- Apnea occurs.
- Sleep disruptions
- Most common type of sleep apnea.
Describe the pathophysiology of OSA.
It occurs during REM sleep.
The relaxation of soft palate, tonsils, and side walls of the throat cause airway narrowing.
The brain will sense the inability to breathe and the person wakes up.
This happens 5 or more times per hour and leads to hypopnea or apnea.
There may be 10-20 seconds of breathing interruptions throughout the night and oxygen saturations can drop as low as 60%
The person has an increased arousal threshold.
What are 2 causes of OSA?
- Anatomic obstruction
- Medical conditions that lead to airway congestion
What are the 10 risk factors for OSA?
- Short, thick neck
- Large tongue or tonsils
- Overbite
- Allergies
- Overweight/Obese
- Aging
- Male
- Family history
- Diabetes
- Hypertension
What are the 5 complications of OSA?
- HTN
- Daytime sleepiness
- Stroke
- CVD
- Increased risk of work-related injuries
What are 6 physical findings of OSA?
- History of loud snoring
- Insomnia
- Morning HA
- Irritability
- Nocturia
- Witnessed Apnea
What will be used to diagnose OSA?
Polysomnogram
Polysomnogram
Mild, Moderate, and Severe. List the correct number of episodes per hour for each category.
- Mild: 5-15 episodes/hour
- Moderate: 15-30 episodes/hour
- Severe: more than 30 episodes/hour
