Sleep and Sleep Disordered Breathing
- related: Pulmonology
- tags: #literature
- source:
To do
- Sleep Disorders - Step 2
- accp board review
- chest: respiratory management of PTs with neuromuscular disease
Normal Physiology
- sleep latency is how long it takes to fall asleep
- sleep efficiency is how much time is spent in sleep
- sleep cycle and sleep stages
- REM sleep and pulmonary disorders
Definition
- sleep disordered breathing is characterized by apnea, hyponea, hypoventilation, RERA
- difference between OSA, OHS
- nocturnal hypoxemia has various pathophysiology
Symptoms
- symptoms of OSA snoring, choking, apneas
- use EPSS for estimating day time sleepiness, >10 is high
- cheynne stokes breathing
Diagnostic testing
- severity of apnea is dependent on AHI, RDI, and RERA
- PSG tracings for sleep disordered breathing
- example PSG tracings
- hypnograms for sleep apnea
- use in lab sleep testing instead of home for complicated sleep apnea
- use maintenance wakefulness test MWT to test how sleepy during day
Sleep Related Disorders
- disorder of insomnia
- circadian rhythm sleep syndrome
- narcolepsy type 1 and 2
- diagnose idiopathic hypersomnia with MSLT and actigraphy
- idiopathic hypersomnia
- exploding head syndrome EHS
- opioid impact on sleep disordered breathing
- use MSLT to diagnose narcolepsy and hypersomnia
- excessive daytime sleepiness EDS
- insufficient sleep syndrome
- restless leg syndrome and periodic limb movement
- parasomnias are movement during sleep
Sleep Devices
Treatment
Obstructive Sleep Apnea
- OSA treatment flow diagram
- conservative management for OSA includes weight loss, devices, and sleep positioning
- nocturnal oxygen does not treat root cause of OSA
- nasal and mandibular surgeries as treatment options for OSA
- hypoglossal nerve stimulator
- eszopiclone is used to help improve adherence to CPAP
- APAP results in lower mean airway pressure compared to CPAP
- CPAP with expiratory pressure relief
Central Sleep Apnea
- CPAP, Bipap, and ASV are main treatment for central sleep apnea
- phrenic nerve stimulation as treatment for central sleep apnea and hypoventilation
- CSA supplemental O2
- PAP therapy does not improve survival in HFrEF patients with CSA
- high altitude can worsen CSA
Hypoventilation
- overview treatment of OHS
- CPAP is main treatment for OSA
- Bipap is alternative treatment to CPAP if hypoventilation and hypoxemia still persists
- ASV can be used if there is low MV
- monitoring of serum bicarb and PaCO2 are used
- NIV treatment of hypercapnic respiratory failure settings
- indication for day time ventilation
- Qualifying Patients for Noninvasive Positive Pressure Ventilation Devices on Hospital Discharge
- initiating nighttime NIV for chronic hypercapnia in COPD
- initiating daytime ventilation for neuromuscular disease patients
- initiating nighttime NIV for chronic hypercapnia in OHS
OSA vs OHS
- CPAP can treat OSA, but pts can still have OHS with hypoxia/hypercapnia
OHS
- Use bipap if pts can't tolerate CPAP pressure
- Add O2 or use AVAPS if still hypoxia
ASV
Literature Notes
- Murray and Nadel Ch 119 Sleep Disordered Breathing
- Murray and Nadel Ch 120 Obstructive Sleep Apnea
- Murray and Nadel Ch 121 Central Sleep Apnea
- Murray and Nadel Ch 122 Sleep Disordered Breathing Treatment
- CHEST sleep review
Links to this note
- Pulmonology
- Murray and Nadel Ch 122 Sleep Disordered Breathing Treatment
- related: Sleep and Sleep Disordered Breathing
- CHEST sleep review
- related: Sleep and Sleep Disordered Breathing
- Murray and Nadel Ch 119 Sleep Disordered Breathing
- narcolepsy type 1 and 2
- initiating nighttime NIV for chronic hypercapnia in COPD
- related: Sleep and Sleep Disordered Breathing
- NIV treatment of hypercapnic respiratory failure settings
- related: Sleep and Sleep Disordered Breathing
- sleep disordered breathing is characterized by apnea, hyponea, hypoventilation, RERA
- related: Sleep and Sleep Disordered Breathing
- hypnograms for sleep apnea
- related: Sleep and Sleep Disordered Breathing
- severity of apnea is dependent on AHI, RDI, and RERA
- related: Sleep and Sleep Disordered Breathing
- use MSLT to diagnose narcolepsy and hypersomnia
- related: Sleep and Sleep Disordered Breathing
- PSG tracings for sleep disordered breathing
- related: Sleep and Sleep Disordered Breathing
- cheynne stokes breathing
- related: Sleep and Sleep Disordered Breathing
- APAP results in lower mean airway pressure compared to CPAP
- related: Sleep and Sleep Disordered Breathing
- ASV adaptive support ventilation
- related: Sleep and Sleep Disordered Breathing
- Bipap is alternative treatment to CPAP if hypoventilation and hypoxemia still persists
- related: Sleep and Sleep Disordered Breathing
- circadian rhythm sleep syndrome
- related: Sleep and Sleep Disordered Breathing
- conservative management for OSA includes weight loss, devices, and sleep positioning
- related: Sleep and Sleep Disordered Breathing
- CPAP, Bipap, and ASV are main treatment for central sleep apnea
- related: Sleep and Sleep Disordered Breathing
- CPAP with expiratory pressure relief
- related: Sleep and Sleep Disordered Breathing
- CSA supplemental O2
- related: Sleep and Sleep Disordered Breathing
- diagnose idiopathic hypersomnia with MSLT and actigraphy
- related: Sleep and Sleep Disordered Breathing
- difference between OSA, OHS
- related: Sleep and Sleep Disordered Breathing
- disorder of insomnia
- related: Sleep and Sleep Disordered Breathing
- eszopiclone is used to help improve adherence to CPAP
- related: Sleep and Sleep Disordered Breathing
- example PSG tracings
- related: Sleep and Sleep Disordered Breathing
- excessive daytime sleepiness EDS
- related: Sleep and Sleep Disordered Breathing
- exploding head syndrome EHS
- related: Sleep and Sleep Disordered Breathing
- high altitude can worsen CSA
- related: Sleep and Sleep Disordered Breathing
- hypoglossal nerve stimulator
- related: Sleep and Sleep Disordered Breathing
- idiopathic hypersomnia
- related: Sleep and Sleep Disordered Breathing
- initiating daytime ventilation for neuromuscular disease patients
- related: Sleep and Sleep Disordered Breathing
- initiating nighttime NIV for chronic hypercapnia in OHS
- related: Sleep and Sleep Disordered Breathing
- nasal and mandibular surgeries as treatment options for OSA
- related: Sleep and Sleep Disordered Breathing
- nocturnal hypoxemia has various pathophysiology
- related: Sleep and Sleep Disordered Breathing
- nocturnal oxygen does not treat root cause of OSA
- related: Sleep and Sleep Disordered Breathing
- opioid impact on sleep disordered breathing
- related: Sleep and Sleep Disordered Breathing
- OSA treatment flow diagram
- overview treatment of OHS
- related: Sleep and Sleep Disordered Breathing
- PAP therapy does not improve survival in HFrEF patients with CSA
- related: Sleep and Sleep Disordered Breathing
- parasomnias are movement during sleep
- related: Sleep and Sleep Disordered Breathing
- phrenic nerve stimulation as treatment for central sleep apnea and hypoventilation
- related: Sleep and Sleep Disordered Breathing
- REM sleep and pulmonary disorders
- related: Sleep and Sleep Disordered Breathing
- restless leg syndrome and periodic limb movement
- related: Sleep and Sleep Disordered Breathing
- sleep cycle and sleep stages
- related: Sleep and Sleep Disordered Breathing
- sleep efficiency is how much time is spent in sleep
- related: Sleep and Sleep Disordered Breathing
- sleep latency is how long it takes to fall asleep
- related: Sleep and Sleep Disordered Breathing
- symptoms of OSA snoring, choking, apneas
- related: Sleep and Sleep Disordered Breathing
- Types of NIV devices
- related: Sleep and Sleep Disordered Breathing
- use in lab sleep testing instead of home for complicated sleep apnea
- related: Sleep and Sleep Disordered Breathing
- use maintenance wakefulness test MWT to test how sleepy during day
- related: Sleep and Sleep Disordered Breathing