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42 terms

Clinical Assessment Ch 19

STUDY
PLAY
Which of the following will assist the RT in predicting sleep apnea
Berlin Questionaire
Which of the following is not likely a symptom of OSA
REM
In which stage of sleep is restorative sleep thought to occur
REM
To meet the difinition criteria for sleep apnea, how many seconds of airflow cessation during sleep must be documented
10 seconds
According to the NHLBI, approximately how many Americans suffer from some type of sleep disorder
40 million
In which stage of sleep does the brain show electrical activity similar to wakefulness on EEG tracings
REM
During which stage of sleep are skeletal muscles partially paralyzed, thus greatly affecting ventilation and maintenance of the upper airway
REM
Which of the following is not a physiologic parameter routinely monitored during the PSG study
Right and left arm
If on assessment the Mallampati score is class 4 the patient would be at high risk fro which type of SDB
OSA
Cheyne-Stokes breathing is most closely associated with which type of SDB
CSA
A patient comment regarding the lack of dreaming could mean the patient is not spending a significan period of sleep in which stage
REM
a reduction in airflow between 4% and 50% of the baseline airflow for at least 10 seconds during sleep defines which of th following
Hypopnea
Which of the following diagnostically defines the presence of moderate sleep apnea
AHI 32
Which of the following is not true regarding SIDS
Peaks at 8 months
which of the following is the first sign of SDB
Snoring
NREM occupies
about 75% of the sleep period normally and includes restorative sleep known as delta sleep
REM occupies
25% of the sleep period and is characterized by active brain activity, dreaming, and partial paralysis of skeletal muscles
Sleep architecture represents
the sleep cycles entered during the sleep period. A histogramof the sleep architecture visually depicts the cycling of sleep stages
The role of the RT
is key during rountine patient assessment through questioning the patient's sleeping habits. Although the physical examination may be normal for the SDB patient
Berlin Questionaire
identifies sleep apnea risk factors
ESS
assesses daytime sleepiness
Montage
A sleep study continously records physiologic data fro at least seventeen sources on the patients head and body. The arrangement of thes data on single page is called a montage
The AHI/apnea-hypopnea index
is the primary diagnostic calculation used to confirm the presence of sleep apnea and to classify it according to mild, moderate, or severe
OSA
occurs when an obstruction of airflow in the upper airway causes air movement into the lungs to cease while thoracic-abdominal efforts to breathe continue.
The Mallampati score
can be easily determined through assessment and a class 3 or 4 score is highly associated with OSA
CSA
results from a lack of physiologic stimulation to breathe causing cessation of airflow and is characterized by the absence of thoracic-abdominal efforts
MSA
is a combination of OSA and CSA. When OSA is treated, CSA renaubs tge cause for sleep apnea
Children with OSA
present with different syptoms thatn expected with adults and may include hyperactivity, aggressive behavior, social awkwardness, poor attention span, poor academic performance, or characteristics of attention deficit/hyperactivity disorder
MSA is
combination of OSA and CSA. When OSA is treated, CSA remains the cause for sleep apnea
RT are valuavle assets to the sleep community beause they are a major segmetn of the workforce conducting
sleep studies in SDC's throughout the con=untry and they have a unique background in ventilation, pulmonary anatomy and physiology, pharmacology, and ardiopulmonary dieseas
Although the results of inspetion, palpation percussion, and auscultation during a physical assessment are frequently nonspecfic and may include
EDS, lethargy, poor concentration, obesity, large or short neck, retrognathia/micrognathia, morning headache, loss of memory or concentrtion, recnt weight gain, erectile dysfunction, nocturnal enuresis, pedal edema, or general tiredness regardless oh how many hours of reported sleep
Diagnostically sleep apnea is defined as the cessation of airflow for at least seconds during sleep caused by an obstruction in the airway, a 4% decrease in Spo2, or producing an EEG arousal for at least seconds.
Although patients may be unaware they have sleep apnea, it is likely they have been told they snore.
Snoring is the noise produced during inspiration during sleep as a result of
soft tissue vibration in the palate andpillar regions of the oropharynx and may eventally lead to the developmetn of significant sleep apnea
EDS is
difficulty staying awake during the day. Patients with sleep apnea will be very conscious of the effects of daytime somnolence on their lifestyle.
The ESS is
an eight-term questionaire that measures daytime sleepiness for the initail screening of sleep disorders.
The Berlin Questionaire focuses on
the risk factors associated with sleep apnea and has a high degree of sensitivity and specificity for predicting sleep apnea.
The two major states of sleep,
NREM and REM, cycle back and forth every 60 to 90 minutes for a total of 4 to 5 cycles during a normal 8 hour sleeping period. Usually, sleep begins at stage 1 NREM, progresses to stage 2, followed by stage 3 NREM as sleep deepens. During NREM the brain is in a state of rest while the body can stillmove and respond to stimuli
As REM sleep is initiated,
the brain becomes more active and the body experiences partial skeletal muscle paralysis with changes in ventilation, blood pressure, and heart rate
What is OSA
obstructive sleep apnea
Sleep Disordered Breathing
OSA-Obstructive sleep apnea, CSA-Central sleep apnea, MSA-Mixed sleep apnea
Assessment of Sleep-Disordered Breathing
Epworth sleepiness scale, Berlin Questionaire, The Polysomnogram
Normal Stages of Sleep
Non-Rapid eye movement sleep, Rapid eye movement sleep