Murray and Nadel Ch 119 Sleep Disordered Breathing

Ventilation, oxygenation, and mechanics during sleep

  • overview pathophysiology of sleep disordered breathing
  • pathophysiology for hypoxemia during sleep
  • patients without OSA can also have hypoventilation or hypoxemia

Identifying pulmonary patients at risks for comorbid sleep disorders

  • Table: signs, symptoms to suggest sleep disordered breathing

Taking a relevant sleep history

  • components of sleep history and physical exam

Questionnaires

Diagnostic sleep testing

  • HSAT: home sleep apnea testing
  • PSG: in lab polysomnography
  • 3 types of common disorder includes: OSA, nocturnal hypoventilation, nocturnal hypoxemia
  • ABG or nocturnal pulse oximetry is required for qualifying home oxygen therapy
  • transcutaneous or ETCO2 are used to determine pressure for NIV
  • overnight oximetry is used to determine treatment efficacy
  • components of PSG

Common Clinical Scenarios to Consider SDB