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EENT
Sleep Apnea
23
Medical
Graduate
09/01/2009

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Cards

Term
What does apnea mean?
Definition
Without breath
Term
Name 3 types of apnea.
Definition
1) Obstructive 2) Central (neural) 3) Mixed
Term
What is obstructive sleep apnea (OSA)?
Definition
A disorder in which complete or partial obstruction of the airway during sleep which causes loud snoring, oxyhemoglobin desaturation and frequent arousals
Term
Describe the epidemiology of OSA.
Definition
4% of US adults, men > women, 12-18M americans
Term
Describe the anatomic pathophysiology of OSA.
Definition
Nasal congestion, physical obstruction (tonsillar hypertrophy), peripharyngeal infiltration of fat/increased size of soft palate or tongue, facial malformation
Term
Describe the neural pathophysiology of OSA.
Definition
Upper airway dilator activity vs. inspiratory pump muscles
Term
What diseases are associated with OSA?
Definition
HTN, pulomnary HTN, CAD, cardiac arrythmia
Term
What are the sites of airway obstruction?
Definition
Nasopharynx, oropharynx, hypopharynx
Term
What could cause airway obstruction in the nasopharynx in OSA?
Definition
Deviated septum or nasal polyps
Term
What could cause airway obstruction in the oropharynx in OSA?
Definition
elongated soft palate, redundant peripharyngeal tissue, enlarged uvula
Term
What could cause airway obstruction in the hypopharynx in OSA?
Definition
Small or receding jaw (micrognathia), enlarged tongue
Term
What is the typical general presentation of OSA?
Definition
Snoring
Term
Name other presentations of OSA.
Definition
nonrestorative sleep, sleepiness, insomnia w/ frequent awakenings, HA, obesity, large neck (>17in), cognitive deficits
Term
What lab value is associated w/ OSA?
Definition
hypercapnia
Term
What is considered the gold standard for dx of OSA?
Definition
Polysmonography (PSG)
Term
What is used to determine one's degree of tiredness?
Definition
Epworth sleepiness scale
Term
What does PSG monitor?
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)
Term
What are risks of untreated sleep apnea?
Definition
MVA, HTN, CAD, CVA, DM
Term
What is used for first line tx of OSA?
Definition
CPAP (continuous positive airway pressure)
Term
What are complications of CPAP?
Definition
1) Sneezing and rhinorrhea 2) dry mucus membranes 3) dermal irritation from mask 4) Non compliance
Term
What is the most common surgery used to tx sleep apnea?
Definition
UPPP (Uvulopalatopharyngoplasty)
Term
Name other surgeries to tx OSA.
Definition
palatoplasty, septoplasty, tonsillectomy, turbinate reduction, tracheotomy, hyoid advancement, mandibular advancement
Term
What are other treatments for OSA?
Definition
Behavioral, positional therapy, wt loss, atrial pacing, meds, oral appliances, trach (Last resort)
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