Obstructive sleep apnoea

Question 1

What causes obstructive sleep apnoea

Answer 1

collapse of the pharyngeal airway

Question 2

Risk factors for obstructive sleep apnoea

Answer 2

• obesity
• male
• hypothyroidism
• smoking
• acromegaly

Question 3

What symptoms might a partner of someone with obstructive sleep apnoea report?

Answer 3

Excessive snoring and periods of apnoea (not breathing)

Question 4

Presenting features of obstructive sleep apnoea

Answer 4

• episodes of apnoea
• snoring
• excessive daytime sleepiness
• waking up unrefreshed from sleep
• restless sleep

Question 5

What are the consequences of obstructive sleep apnoea

Answer 5

• compensated respiratory acidosis
• hypertension

Question 6

How is sleepiness assessed in patients with obstructive sleep apnoea?

Answer 6

Epworth Sleepiness Scale - questionnaire completed by patient +/- partner

Question 7

What diagnostic tests are used to diagnose obstructive sleep apnoea?

Answer 7

Sleep studies (polysomnography):
* simple - pulse oximetry monitoring at night
* respiratory polygraphy - can be done at home
* complex - polysomnography measuring EEG, respiratory airflow, EMG, ECG, and pulse oximetry.

Question 8

How is obstructive sleep apnoea managed

Answer 8

• weight loss
• Continuous positive airway pressure (CPAP)
• excessive daytime sleepiness - inform DVLA
• CPAP intolerant - intra-oral devices (mandibular advancement)
• above not tolerated = surgery (uvulopalatopharyngoplasty)