obstructive sleep apnoea

Question 1

what are predisposing factors for OSA?

Answer 1

obesity
male, smoker, alcohol
idiopathic pulmonary fibrosis
macroglossia: acromegaly, hypothyroidism, amyloidosis
large tonsils
Marfan’s syndrome
NM disease- MND
micrognathia- lower jaw smaller than normal

Question 2

what are the symptoms of OSA?

Answer 2

daytime somnolence
morning headache
reduced memory/attention
irritability depression

Question 3

what are the complications of OSA?

Answer 3

compensated respiratory acidosis T2RF
pulmonary hypertension

Question 4

how do you assess sleepiness in OSA?

Answer 4

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 5

what are diagnostic tests for OSA?

Answer 5

sleep studies (polysomnography) - ranging from monitoring of pulse oximetry at night to full polysomnography where a wide variety of physiological factors are measured including EEG, respiratory airflow, thoraco-abdominal movement, snoring and pulse oximetry

Question 6

what is the management of OSA?

Answer 6

weight loss
CPAP 1st line in mod-severe OSA after weight loss
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

inform DVLA if excessive daytime sleepiness

limited evidence to support use of pharmacological agents

Question 7

what is OSA?

Answer 7

Intermittent closure/collapse of pharyngeal airway → apnoeic episodes during sleep.