Term
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Definition
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Term
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Definition
1) Obstructive 2) Central (neural) 3) Mixed |
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Term
What is obstructive sleep apnea (OSA)? |
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Definition
A disorder in which complete or partial obstruction of the airway during sleep which causes loud snoring, oxyhemoglobin desaturation and frequent arousals |
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Term
Describe the epidemiology of OSA. |
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Definition
4% of US adults, men > women, 12-18M americans |
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Term
Describe the anatomic pathophysiology of OSA. |
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Definition
Nasal congestion, physical obstruction (tonsillar hypertrophy), peripharyngeal infiltration of fat/increased size of soft palate or tongue, facial malformation |
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Term
Describe the neural pathophysiology of OSA. |
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Definition
Upper airway dilator activity vs. inspiratory pump muscles |
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Term
What diseases are associated with OSA? |
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Definition
HTN, pulomnary HTN, CAD, cardiac arrythmia |
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Term
What are the sites of airway obstruction? |
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Definition
Nasopharynx, oropharynx, hypopharynx |
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Term
What could cause airway obstruction in the nasopharynx in OSA? |
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Definition
Deviated septum or nasal polyps |
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Term
What could cause airway obstruction in the oropharynx in OSA? |
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Definition
elongated soft palate, redundant peripharyngeal tissue, enlarged uvula |
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Term
What could cause airway obstruction in the hypopharynx in OSA? |
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Definition
Small or receding jaw (micrognathia), enlarged tongue |
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Term
What is the typical general presentation of OSA? |
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Definition
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Term
Name other presentations of OSA. |
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Definition
nonrestorative sleep, sleepiness, insomnia w/ frequent awakenings, HA, obesity, large neck (>17in), cognitive deficits |
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Term
What lab value is associated w/ OSA? |
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Definition
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Term
What is considered the gold standard for dx of OSA? |
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Definition
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Term
What is used to determine one's degree of tiredness? |
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Definition
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Term
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Definition
Sleep stages (EEG and eye movements), respiratory effort (chest movement), nasal and oral airflow, arterial O2 sats, cardiac rhythm and rate, body position, limb movements (EMG) |
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Term
What are risks of untreated sleep apnea? |
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Definition
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Term
What is used for first line tx of OSA? |
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Definition
CPAP (continuous positive airway pressure) |
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Term
What are complications of CPAP? |
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Definition
1) Sneezing and rhinorrhea 2) dry mucus membranes 3) dermal irritation from mask 4) Non compliance |
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Term
What is the most common surgery used to tx sleep apnea? |
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Definition
UPPP (Uvulopalatopharyngoplasty) |
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Term
Name other surgeries to tx OSA. |
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Definition
palatoplasty, septoplasty, tonsillectomy, turbinate reduction, tracheotomy, hyoid advancement, mandibular advancement |
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Term
What are other treatments for OSA? |
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Definition
Behavioral, positional therapy, wt loss, atrial pacing, meds, oral appliances, trach (Last resort) |
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