Chapter 33 Egan's

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The definition of sleep apnea uses what criteria for defining an episode of apnea?

10 sec

What value for the apnea-hypopnea index (AHI) is consistent with moderate obstructive sleep apnea?

15-30

What percent of the adult population is believed to have obstructive sleep apnea?

2%-4%

What are the criteria to define hypopnea?

30% decrease in airflow and 4% oxygen desaturation

What is the amount of CPAP that is typically required to abolish upper airway obstruction in patients with OSA?

7.5-12.5 cmH2O

Why should the patient with obstructive sleep apnea not use alcohol?

Alcohol decreases the arousal threshold

What term is used to describe CPAP units that use a computer to adjust CPAP levels as needed by the patient during sleep?

Auto-CPAP

Which of the following behavioral interventions is least useful for the treatment of sleep apnea?

Avoidance of daytime naps

Which of the following are interventions used in the management of obstructive sleep apnea?

Behavioral Medical Surgical

In what way do BiPAP units differ from CPAP units?

BiPAP applies different pressure levels on inspiration and exhalation

Which of the following medical therapies is considered first-line treatment for obstructive sleep apnea (OSA)?

CPAP

When differentiating between central and obstructive sleep apnea, which of the following "channels" or parameters would reflect vastly different results during an apneic episode or event?

Chest wall and abdominal effort

What is the name of the respiratory pattern where a crescendo-decrescendo pattern of hyperpnea alternates with periods of apnea?

Cheyne-Stokes

Which of the following conditions are associated with central apnea?

Congestive heart failure Primary central nervous system lesions High-altitude hypoxemia

Which of the following are common side effects of positive-pressure therapy?

Dry nasal mucosa Claustrophobia Skin irritation

Which of the following complaints is frequently seen in a patient with obstructive sleep apnea?

Excessive daytime sleepiness

Which of the following parameters is not typically monitored with a polysomnogram?

Exhaled PCO2

Available evidence has shown that bilevel pressure is associated with better patient compliance than the conventional CPAP.

False

Central sleep apnea occurs more often than obstructive sleep apnea.

False

What term is used to describe a significant decrease in airflow during sleep but not a complete cessation of breathing?

Hypopnea

What is believed to be the cause of systemic hypertension in patients with sleep apnea?

Increased sympathetic tone

Which of the following are parameters used to confirm the metabolic syndrome associated with obstructive sleep apnea?

Insulin resistance Hypertension Impaired glucose intolerance

Which of the following are true about obstructive sleep apnea (OSA)?

It has an equivalent prevalence to asthma in the general population. It has an equivalent prevalence to diabetes in the general population. The spectrum of the disease includes sleep disruption related to increased airway resistance

Which of the following characteristics are typically associated with sleep apnea?

Male patient Over the age of 40 years Loud snoring during sleep

Which of the following physical exam findings are associated with obstructive sleep apnea?

Microcephaly Macroglossia Deviated nasal septum

Which of the following factors has been shown to positively correlate with obstructive sleep apnea?

Obesity of the upper body

What is considered to be the major problem with the use of CPAP in patients with obstructive sleep apnea?

Patient compliance

How does CPAP improve breathing in the patient with OSA?

Pneumatic splinting of the upper airway

Which of the following conditions are associated with untreated obstructive sleep apnea?

Pulmonary hypertension Heart failure Myocardial infarction

What is the primary cause of obstructive sleep apnea?

Small or unstable pharyngeal airway


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