Obstructive sleep apnoea

Question 1

Predisposing factors of OSA?

Answer 1

• obesity
• macroglossia: acromegaly, hypothyroidism, amyloidosis
• Large tonsils
• Marfan’s syndrome

Question 2

Consequences of OSA

Answer 2

• daytime somnolence
• compensated respiratory acidosis
• hypertension

Question 3

Assessment of sleepiness includes?

Answer 3

• Epworth Sleepiness Scale- questionnaire completed by patient +/- partner
• Multiple Sleep Latency Test (MSLT) - measures the time to fall asleep in a dark room (using EEG criteria)

Question 4

Management of OSA?

Answer 4

• weight loss
  • continuous positive airway pressure (CPAP)is first line for moderate or severe OSAHS
  • intra-oral devices (e.g. mandibular advancement) may be used if CPAP is not tolerated or for patients with mild OSAHS where there is no daytime sleepiness
  • theDVLA should be informedif OSAHS is causing excessive daytime sleepiness
  • limited evidence to support use of pharmacological agents

Question 5

Following weight loss what is the first-line treatment for moderate/severe OSA?

Answer 5

CPAP - Continuous positive airway pressure Ventilation