INSTRUCTIONS Poor sleep, hazardous breathing: An overview of obstructive sleep apnea
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Poor sleep, hazardous breathing: An overview of obstructive sleep apnea
General Purpose: To provide information on the diagnosis and treatment of OSA. Learning Objectives: After reading the article and taking this test, you should be able to: 1. Identify the risk factors for and signs and symptoms, pathophysiology, and potential consequences of OSA. 2. Discuss the diagnosis and treatment of OSA.
- Which statement is true regarding OSA?
- OSA is characterized by repeated episodes of lower airway obstruction during sleep.
- Oxygen saturation levels remain stable during periods of apnea in OSA.
- Sleep arousals often last 15 minutes or longer before sleep is resumed.
- Persons with OSA usually are unaware that their sleep has been disrupted.
- Risk factors for OSA include
- female gender.
- older age.
- Which risk factor makes a person nearly three times more likely to have OSA than persons without it?
- growth hormone deficiency
- lower airway soft-tissue abnormalities
- male gender
- current smoker
- Airway obstruction causing disrupted breathing leads to
- decreased breathing effort.
- decreased pharyngeal muscle activity.
- In severe cases each episode of apnea typically lasts
- 5 to 10 seconds.
- 12 to 18 seconds.
- 20 to 40 seconds.
- 45 to 60 seconds.
- The negative intrathoracic pressure that results from OSA causes
- increased ventricular afterload.
- increased left ventricular compliance.
- decreased myocardial oxygen demand.
- decreased pulmonary artery pressures.
- In cases without typical symptoms, OSA is clinically defined by an AHI of
- 10 or greater.
- 15 or greater.
- The most frequent symptom of OSA is
- nocturnal gasping.
- Comorbid conditions increasing risk of OSA include all except
- metabolic syndrome.
- irritable bowel syndrome.
- The most common craniofacial and soft-tissue abnormality in OSA is
- a nonspecific narrowing of the oropharyngeal airway.
- tonsillar hypertrophy.
- Home-based sleep studies are a reasonable option for patients with
- major comorbid conditions.
- an intermediate index of suspicion for OSA.
- atypical symptoms.
- a high likelihood of moderate-to-severe OSA.
- During home-based sleep studies, the authors recommend documenting
- an ECG.
- a chin electromyogram.
- an electrooculogram.
- The treatment of choice for OSA is
- CPAP during sleep.
- medication and supplemental oxygen.
- upper airway surgery.
- an adjustable OA during sleep.
- The preferred method for delivering CPAP for mouth breathers is via a
- non-rebreathing face mask.
- nasal mask.
- nasal pillow.
- full-face mask.
- Which of the following is true about CPAP?
- Asthma is an absolute contraindication to CPAP.
- Adverse effects of CPAP can include pulmonary hypertension.
- Adding humidification may lessen some adverse effects of CPAP.
- Nasal saline sprays must be avoided when using CPAP.
- OAs for the treatment of OSA
- serve as a splint for the pharyngeal soft tissues.
- advance the mandible and tongue relative to the maxilla.
- are used to prevent teeth grinding during sleep.
- are as effective as CPAP.
- Which of the following is generally used as part of primary OSA treatment?
- bariatric surgery
- positional therapy
- supplemental oxygen
- Patient adherence to CPAP therapy is most often determined in about
- 1 week.
- 2 weeks.
- 3 weeks.
- 6 weeks.