Obstructive sleep apnoea

Question 1

Obstructive sleep apnoea

Answer 1

Collapse of pharyngeal airway during sleep

Characterised by apnoea episodes

Question 2

Risk factors

Answer 2

Middle age

Male

Obesity

Alcohol

Smoking

Macroglossia: acromegaly, hypothyroidism, amyloidosis

Marfan’s

Large tonsils

Question 3

Features

Answer 3

Apnoea during sleep

Snoring

Morning headache

Waking up unrefreshed from sleep

Daytime sleepiness

Concentration problems

Reduced oxygen sats during sleep

Question 4

Consequences

Answer 4

Daytime somnolence

Compensated respiratory acidosis

Hypertension

Question 5

Assessment of sleepiness

Answer 5

Epworth sleepiness scale (questionnaire)

Multiple sleep latency test (measure time to fall asleep in dark room and uses EEG criteria)

Question 6

Diagnostic tests

Answer 6

Polysomnography

Question 7

Management

Answer 7

Referral to ENT specialist or specialist sleep clinic

Weight loss

CPAP first line for moderate or severe

Intra-oral devices if CPAP not tolerated and mild

DVLA should be informed if causing excessive daytime sleepiness