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32 Cards in this Set
- Front
- Back
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What is the classic prevalence of OSA in men vs women?
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Men 4%
Women 2% |
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How is OSA defined?
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AHI of >5 plus EDS
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What % of men/women have an AHI >5 but w/o EDS?
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24% men, 9% women
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What's a hypopnea?
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Discernable reduction with 4% desat
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What's an apnea?
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10 sec cessation
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What is "sleepiness"?
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>2x/week sleepiness that interferes with daily living
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What is the best predictor of OSA?
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Obesity
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What neck circumference predicts osa in men/women?
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>17 in in men, 16 in women
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What are 2 other findings in osa?
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-Hypertension
-Narrowed oropharynx |
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What are 3 types of PSG studies?
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-Baseline study
-Split nite study -Cpap/bipap tritation study |
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What are 3 types of apneas?
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central
obstructive mixed |
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what is the difference between central and obstructive apneas?
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central - no resp effort
obstructive - resp effort persists |
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what is a mixed apnea?
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initially no resp effort, then it kicks in before airflow does
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A hypopnea is:
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apnea >/=10 sec with a 4% desat
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What is a rera?
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Reduction in airflow for 10sec or more but not meeting criteria for hypopnea/apnea
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What is the AHI?
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Apneas + Hypopneas
divided by Total Sleep Time hours |
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What's an RDI?
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Same as the AHI
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ODI
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oxygen desat index - number of 4% desats per hour
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When will medicare/caid cover CPAP for osa?
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AHI >15
or AHI >5 with comorbidities of HTN, stroke, sleepy, IHD, ischemia, depression |
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What are the txmt options for OSA?
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CPAP
Oral appliances Surgery |
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What type of patients with OSA are appropriate for oral applicances?
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Mild to mod osa
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What are oral applicances good vs bad at?
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Good for reducing AHI
Less good at resolving sleepiness |
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What is the most widely done surgical procedure for osa?
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uvulpalatopharyngoplasty UPP
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Cure rate of UPP for mild-mod osa:
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30-40%
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What type of surgery has comparable success rates to cpap for severe osa?
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Maxillomandibular advancement
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What are 4 types of patients who are NOT candidates for auto-titrating cpap devices?
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-CHF
-Significant lung disease -Non-snorers -Pts with central sleep apnea |
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What are 4 types of CV disease that have high percentages of patients with significant sleep-disordered breathing?
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Cardiac disease patients
CHF patients Stroke survivors Drug-resistent HTNsive pts |
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What are patients with OSA at increased risk for?
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-Stroke
-2-4x increase risk of afib and ventricular arrhythmias |
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What are 2 benefits of positive pressure therapy for OSA?
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-Decreased MVA's
-Improved neurocognitive functioning |
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How does CPAP affect bp?
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Both day and nite BP decrease
Improves LV function |
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What metabolic disorders are associated with OSA?
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Insulin resistance
Glucose intolerance |
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How is sleepiness measured:
-subjectively -objectively |
subj - epworth sleep scale
obj - MSLT |
