Trouble falling/staying asleep
Insomnia
A disorder characterized by the repetitive stopping or reduction of both air flow and ventilatory effort during sleep
Central Sleep Apnea
Score that is frequently used in physician notes to describe abnormalities of the soft palate and uvula
The Mallampati classification score
Common name for In-home, unattended, portable monitoring
Home Sleep Test (HST)
The term used to describe the total number of events such as apneas and RERAs per hour of sleep?
RESPIRATORY DISTURBANCE INDEX
Slowed, shallow, restricted breathing that occurs in 10-second or longer 'episodes' repeatedly during sleep
Hypopnea
When the genioglossus muscle fails to oppose the forces that tend to collapse the airway passage during inspiration, the tongue moves into the oropharyngeal area and obstructs the airway.
Obstructive sleep apnea
Soft palate, hard palate, uvula, pillars are easily seen
Class 1
It can be done in the patient’s home and/or in areas without ready access to sleep centers
Convenience
Patient acceptance
Easily can be performed over multiple nights
Decreased cost
Advantages of HST
These signs below are known as
Excess weight
Large neck size
Hypertension
Risk factors of OSA
Repeatedly feel excessively tired during the day (called excessive daytime sleepiness) or sleep longer than usual at night
Hypersomnia
Usually begins as central apnea followed by the onset of ventilatory effort without air flow
Mixed Apnea
Soft palate, hard palate, portion of uvula are seen
Class 2
Possible data loss or distortion
The potential for interpretation errors resulting from limited data
Inability to perform subsequent multiple sleep latency testing according to standard protocol
Varied sensor technology
No published standards for scoring or interpretation
Disadvantages of HST
Is useful in the management of the patient with obstructive sleep apnea and prevents airway collapse
CPAP
Day/night confused - physical, mental, and behavioral changes that follow a 24-hour cycle
Circadian rhythm sleep disorders
Cardinal features include:
Obstructive apneas
Hypopneas
Respiratory effort–related arousals (RERAs)
Caused by recurring collapse of the upper airway during sleep
Obstructive Sleep Apnea (OSA)
Soft palate, only the base of uvula are seen
Class 3
A specialized sleep test that monitors and records a number of physiologic parameters that occur during sleep
Polysomnogram
A 55 YEAR-OLD , 90 KG MAN IS UNDERGOING POLYSOMNOGRAPHY. THE RESPIRATORY THERAPIST OBSERVES THAT THE PATIENT CONTINUES TO HAVE OBSTRUCTIVE APNEIC EVENTS ON NASAL CPAP AT 4 CMH2O. THE THERAPIST SHOULD????
A. INITATE NPPV VIA NASAL PILLOWS
B. ADD OXYGEN @ 2L/MIN
C. INCREASE THE CPAP PRESSURE
D. TERMINATE THE STUDY
C. INCREASE THE CPAP PRESSURE
A sleep disorder that involves unusual and undesirable physical events or experiences that disrupt your sleep
Parasomnias
PRIMARY CENTRAL SLEEP APNEA AND SECONDARY SLEEP APNEA ARE CLASSIFIED
CENTRAL SLEEP APNEA
Only the hard palate is seen
Class 4
IF A CPAP SYSTEM IS LOSING PRESSURE IN THESYSTEM, THE THERAPIST SHOULD OBSERVE THE SYSTEM FOR __________ AND __________ AS POSSIBLE CAUSES.
LEAK AND INSUFFICIENT FLOW
A sleep study is done on a patient that revealed the patient had 48 apneas and 53 hypopneas over 8 hours of total sleep time. What is the patient’s AHI? How would you treat it?
48+53= 101 101/8= 12.6
Start CPAP at low level or Start CPAP to achieve an AHI of less than 5