Sleep Apnea - Respiratory Care Pathophysiology (Video Notes)

A set of vocabulary flashcards covering key terms and concepts from the Sleep Apnea lecture notes.

Sleep-related breathing disorders

A group of disorders with abnormal breathing during sleep, including obstructive sleep apnea, central sleep apnea, mixed sleep apnea, and sleep-related hypoventilation/hypoxemia syndromes.

Obstructive Sleep Apnea (OSA)

Blockage of ventilation due to upper airway obstruction with no airflow despite chest and abdomen movement.

Central Sleep Apnea (CSA)

Repetitive stopping or reduction of both airflow and ventilatory effort during sleep.

Mixed Sleep Apnea

A combination of obstructive and central sleep apnea; usually begins as CSA and subsequently includes obstructive events.

Sleep-related hypoventilation/hypoxemia syndromes (SRHHS)

Broad range of sleep disorders including obesity hypoventilation syndrome and COPD-sleep apnea overlap.

Genioglossus muscle

Primary tongue protruder whose failure to oppose airway collapse can cause airway obstruction during inspiration.

Macroglossia

Enlarged tongue that can contribute to airway obstruction in sleep.

Micrognathia

Recessed or small jaw that can narrow the airway and predispose to OSA.

Obesity (excess weight)

Excess body weight a major risk factor for upper airway obstruction during sleep.

Neck circumference >17 inches

Larger neck size associated with increased risk of airway collapse during sleep.

Enlarged tonsils/adenoids

Airway tissue overgrowth that can contribute to obstruction in sleep apnea.

Deviated nasal septum

Nasal structural deviation that can worsen airway resistance during sleep.

Laryngeal stenosis

Narrowing of the laryngeal airway increasing obstruction during sleep.

Vocal cord dysfunction

Abnormal vocal cord mobility or function contributing to airway obstruction.

Age >65

Older age as a demographic risk factor for sleep apnea.

Family history

Genetic or familial tendency to develop sleep-disordered breathing.

Smoking

Tobacco use associated with increased risk of sleep apnea due to airway inflammation.

Alcohol and sedatives

Substances that can worsen airway collapse during sleep by relaxing airway muscles.

Apnea-Hypopnea Index (AHI)

Number of apneas plus hypopneas per hour of sleep; used to quantify OSA severity.

Respiratory Disturbance Index (RDI)

Number of apneas and hypopneas per hour (often used interchangeably with AHI).

AASM severity thresholds

Severity categories for OSA: Normal AHI

Cheyne-Stokes breathing

A central sleep apnea pattern with cyclical waxing and waning tidal volumes often seen with CHF.

Hyperventilation-related CSA

CSA associated with hyperventilation; includes primary CSA, Cheyne-Stokes, and altitude-related breathing.

Hypoventilation-related CSA

CSA due to underlying CNS disease, CNS-suppressing drugs, neuromuscular disease, or severe pulmonary mechanics disorders.

Obesity Hypoventilation Syndrome (OHS) / Pickwickian syndrome

Sleep-related hypoventilation in obese individuals; sometimes called Pickwickian syndrome.

Cross-over syndrome (COPD overlap)

Overlap of COPD with sleep apnea, complicating diagnosis and treatment.

Polysomnography

Sleep study that measures EEG, EOG, EMG plus respiratory parameters to diagnose sleep disorders.

Epworth Sleepiness Scale

Questionnaire to assess daytime sleepiness and risk of OSA; scoring guides risk level.

Mallampati classification

Class I–IV grading of oropharyngeal space visibility used to predict airway obstruction risk.

Polysomnography-monitored variables (typical list)

Variables measured during PSG: sleep stages (EEG), eye movements (EOG), muscle tone (EMG), respiratory effort, airflow, snoring, SpO2, ECG, body position, limb movements.

CPAP (Continuous Positive Airway Pressure)

Device delivering constant positive airway pressure to keep the airway open during sleep.

BPAP/VPAP (Bi-level/Variable Positive Airway Pressure)

Devices delivering two pressures (IPAP/EPAP) to assist ventilation; includes pressure support.

IPAP

Inspiratory positive airway pressure; higher pressure during inhalation.

EPAP

Expiratory positive airway pressure; pressure maintained during exhalation.

Pressure support (IPAP - EPAP)

The difference between IPAP and EPAP providing additional ventilation support.

Uvulopalatoplasty (UPP)

Surgical removal of soft palate tissue and uvula to widen the airway.

Mandibular advancement surgery

Surgical procedure that moves the lower jaw forward to enlarge the upper airway.

Tracheostomy

Surgical opening of the trachea to bypass upper airway obstruction.

Sawtooth waves

EEG pattern typical of REM sleep; used in sleep studies to identify sleep stages.

REM sleep

Rapid Eye Movement sleep, a distinct sleep stage associated with dreaming and sawtooth EEG patterns.