2023-10-08T21:53:23+03:00[Europe/Moscow] en true <p>men</p>, <p>during sleep, patient breathing repeatedly stops &amp; starts intermittently; due to throat muscles relaxing and blocking upper airway </p>, <p>obesity (BMI &gt;35), family history, type 2 dm, HF, afib, stroke, treatment-resistant HTN</p>, <p>high-risk driving occupation, daytime sleepiness, sleep dissatisfaction </p>, <p>no significant CVD comorbidity </p>, <p>undergoing bariatric surgery; treatment-resistant HTN</p>, <p>loud snoring, nocturnal choking, gasping, daytime sleepiness, hx of drowsy driving </p>, <p>airflow cessation &gt;= 10 sec</p>, <p>airflow reduction&gt;=10 sec + 3-4% OxyHb desaturation; arousal from sleep</p>, <p>epileptiform EEG, limb movement, nocturnal arrhythmia </p>, <p>AHI &gt;= 5 &amp; &lt; 15/hr</p>, <p>AHI &gt;=15 &amp; 30/hr</p>, <p>AHI&gt;=30 hr</p>, <p>CPAP, weight reduction, surgery, sleep positions</p>, <p>CNS depressants; weight gain</p>, <p>alcohol, opioids, benzos</p>, <p>ACEi; can cause inflammation/cough</p>, <p>patients with residual daytime sleepiness despite CPAP use</p>, <p>Sunosi </p>, <p>modafinil, armodafinil, soliramefetol, pitolisant</p>, <p>a</p>, <p>c</p>, <p>a</p>, <p>75 mg OD; titrate every 3 days to max dose </p>, <p>37.5 mg OD</p>, <p>37.5 mg OD; 75 mg OD after 7 days </p>, <p>37.5 mg OD; no titration </p>, <p>f; not recommended </p>, <p>a</p>, <p>increased BP/HR, psychiatric symptoms </p>, <p>HTN</p>, <p>underlying cause treatment; CPAP</p>, <p>Wakix </p> flashcards
Sleep Apnea

Sleep Apnea

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  • men

    Prevalence of OSA is highest in _______.

  • during sleep, patient breathing repeatedly stops & starts intermittently; due to throat muscles relaxing and blocking upper airway

    How does sleep apnea occur?

  • obesity (BMI >35), family history, type 2 dm, HF, afib, stroke, treatment-resistant HTN

    Risk factors for OSA? (7)

  • high-risk driving occupation, daytime sleepiness, sleep dissatisfaction

    Who should get screened for OSA? (3)

  • no significant CVD comorbidity

    When can we conduct an in-home sleeping test?

  • undergoing bariatric surgery; treatment-resistant HTN

    If a patient has no symptoms of OSA, we should still evaluate them if they __________ or ___________

  • loud snoring, nocturnal choking, gasping, daytime sleepiness, hx of drowsy driving

    Symptoms of OSA? (5)

  • airflow cessation >= 10 sec

    Apnea =

  • airflow reduction>=10 sec + 3-4% OxyHb desaturation; arousal from sleep

    Hypopnea = (2)

  • epileptiform EEG, limb movement, nocturnal arrhythmia

    What are other sleep measures we can try when diagnosing sleep apnea? (3)

  • AHI >= 5 & < 15/hr

    Mild OSA =

  • AHI >=15 & 30/hr

    Moderate OSA =

  • AHI>=30 hr

    Severe OSA =

  • CPAP, weight reduction, surgery, sleep positions

    Nonpharmacologic options for OSA? (4)

  • CNS depressants; weight gain

    Patients who have OSA should avoid all _________ and drugs that promote __________.

  • alcohol, opioids, benzos

    Which drugs should be avoided in OSA? (3)

  • ACEi; can cause inflammation/cough

    Which drug should be monitored? Why?

  • patients with residual daytime sleepiness despite CPAP use

    Who should receive wake-promoting medications?

  • Sunosi

    Soliramefetol =

  • modafinil, armodafinil, soliramefetol, pitolisant

    What are medications used to promote wakefulness? (4)

  • a

    Which is a a DNRI?

    a) Soliramefetol

    b) Modafinil

    c) Pitolisant

    d) Armodafinil

  • c

    Which is an H3 receptor antagonist?

    a) Soliramefetol

    b) Modafinil

    c) Pitolisant

    d) Armodafinil

  • a

    Which requires titration?

    a) Soliramefetol

    b) Modafinil

    c) Pitolisant

    d) Armodafinil

  • 75 mg OD; titrate every 3 days to max dose

    Solriamfetol narcolepsy dosing?

  • 37.5 mg OD

    Solriamfetol OSA dosing?

  • 37.5 mg OD; 75 mg OD after 7 days

    Soliramfetol moderate renally impaired dosing?

  • 37.5 mg OD; no titration

    Soliramfetol severe renal impaired dosing?

  • f; not recommended

    Soliramfetol can be used in ESRD; just at a much lower dose. T/F?

  • a

    Which is contraindicated with MAOIs?

    a) Soliramefetol

    b) Modafinil

    c) Pitolisant

    d) Armodafinil

  • increased BP/HR, psychiatric symptoms

    Warnings/Precautions in Soliramfetol use? (2)

  • HTN

    OSA can lead to the development of ______.

  • underlying cause treatment; CPAP

    What are the first-line treatments for OSA? (2)

  • Wakix

    Pitolisant =