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/ Sleep Apnea
Can you name the Sleep Apnea ?
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Defined by extreme obesity and alveolar hypoventilation during wakefulness.
Snoring does not necessarily mean that you will develop ____
The crash record for people with 15 or more sleep apnea episodes per hour is __x normal.
Most consistently successful treatment for OSAH if the patient can tolerate it. Provides a pneumatic splint to keep the airway from collapsing.
Improves mood and functional status in patients, decreases incidence of MVA, requires a sleep study to adjust the pressure, varying rates of compliance, CLOSE FOLLOW-UP IS KEY
Name a physician responsibility for sleep apnea.
have a plan of follow-up to determine the effectiveness of treatment
______ sleep apnea starts as an upper airway blockage despite airway drive being present.
In mild to moderate cases of OSAH, ______ repositioning may be all that is needed.
Ceased respiration for more than 10 seconds.
Is caused by repetitive upper airway obstruction during sleep due to narrowing or collapse of the respiratory passages.
Pulmonary HTN leads to ______ ventricular failure and peripheral edema.
Characterized by chronic hypercapnia and hypoxemia in the absence of identifiable neurologic disease, respiratory muscle weakness, or mechanical ventilatory defects.
More prevalent hypoventilation disorder.
80% of those affected go undiagnosed
What is being monitored in polysomnography?
Name a clinical symptom of OSAH that may be denied by the patient.
Causes of chronic hypoventilation include impaired respiratory drive, defective neuromuscular system, and impaired ________ apparatus.
Surgical options for OSAH.
Genioglossus advancement, tracheostomy, and many more
Decreased muscle tone during sleep combines with gravity to exacerbate the airway narrowing, often resulting in _____
O2 sat oximetry can be used to confirm the dx or sleep apnea if there are at least _____ episodes/hour.
Negative results do not exclude the diagnosis and a full sleep study is still required if the problem is suspected.
Name a risk for a patient with Sleep Apnea.
Number of apneic episodes/hour
Most patients are obese, have peri-pharyngeal fat infiltration, large necks, and sometimes have a large tongue or soft palate.
Sleep-related MVAs comprise about ____% of all crashes.
Multiple studies show CPAP dramatically reduces this rate.
The crash record for people with 5 sleep apnea episodes per hour is ____x normal
Gold standard in the diagnosis of sleep apnea.
Name a treatment for mild OSAH
Enlargement of the right ventricle due to high blood pressure in the lungs usually caused by chronic lung disease.
Spinal cord injury at the cervical level, or motor neuron disease in which the upper and lower motor neurons die, resulting in muscle atropy.
Respiratory muscle dysfunction due to myasthenia gravis or muscular dystrophy
In William Osler's time, OHS was called the _____ syndrome.
The body recognizes that it is more efficient to tolerate an elevated PaCO2 by reseting the set point of the CNS receptors, hypoventilating and leaving it to the kidneys to compensate
Recognizes the partial pressures of O2.
The prototype of OSAH is a middle aged male, hypertensive, obese and _______.
Structurally abnormal or 'crowded' upper airway.
Diminished movement of air for more than 10 seconds.
In OSAH, the pharynx is abnormal in size and/or _______
The hallmark of ______ is an elevation of the alveolar pressure of carbon dioxide (pCO2) and hence, of arterial pCO2.
_____ sleep apnea starts in the brain and features a sudden loss of the normal drive to breathe.
In OSAH, complete obstruction of the airway occurs, resulting in continued ventilatory drive in the presence of a blocked airway, lasting more than ____ seconds.
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