THERAPEUTICS L15 EX1 (SLEEP APNEA) (CARRIS)

T/F: Humans need to breathe.

Define central sleep apnea

Neurologic condition, no brain breathe during sleep response

Define obstructive sleep apnea (OSA)

Relaxation of back of throat muscles, close throat

Partial obstruction of the airway results in ___________

snoring

Define apnea

Cessation of airflow for at least 10 seconds

Define hypopnea

Reduction in airflow by at least 30% for at least 10 seconds with decrease in oxygen saturation

Define Apnea Hypopnea Index

Number of apneas and hypopneas per hour of sleep

What Apnea Hypopnea Index (AHI) range is classified as mild OSA?

5-14

What Apnea Hypopnea Index (AHI) range is classified as moderate?

15-29

What Apnea Hypopnea Index (AHI) range is classified as severe?

30+

Populations at risk for OSA? (three key ones)

1. Diabetes

2. Hypertension

3. Obesity

What does STOP-Bang stand for?

S = SNORE loudly?

T = TIRED during the day?

O = anyone OBSERVED you stop breathing during sleep?

P = high blood PRESSURE

B = BMI > 35 kg/m2

A = AGE > 50

N = NECK > 40 cm (15.7 in)

G = GENDER (male)?

What STOP-Bang score puts someone at high risk for OSA?

3+

What STOP-Bang score indicates low risk for OSA?

0-2

What is STOP-Bang? (not the full acronym, just what is it)

Sleep Apnea Screening Tool

Sleep lab tests? (two)

1. Polysomnography (PSG)

2. Home sleep testing

Describe polysomnography (PSG)

Overnight test

Gold standard for OSA diagnosis

Describe Home sleep testing

Records less information than PSG

Cost-effective, convenient

Great for high pretest probability

Might require further eval

Adverse outcomes of sleep apnea can include? (three broad areas)

1. Hypertension

2. Cardiometabolic issues

3. Cognition and psychiatric complications

Describe "non-dipping"

Blood pressure does not go down during sleep

Can be caused by sleep apnea

Mainstay OSA treatment?

Continuous Positive Airway Pressure (CPAP)

Explain the relationship between CPAP therapy and hypertension

CPAP can help control hypertension by re-dipping non-dippers

Benefits of CPAP therapy include? (five)

1. Blood pressure

2. Alertness

3. Mood

4. Quality of life

5. Insulin sensitivity

Side effects of CPAP therapy? (five)

1. Nasal congestion (nasal sprays work)

2. Claustrophobia (mask bad)

3. Difficulty exhaling (reduce pressure to treat)

4. Bruised nasal ridge (mask bad)

5. Aerophagia (need some antacids)