Obstructive Sleep Apnoea

Question 1

What is obstructive sleep apnoea?

Answer 1

Intermittent closure of the pharyngeal airway during sleep which causes significant daytime symptoms

Question 2

Who is the typical patient with OSA?

Answer 2

Male

Obese

Question 3

What is the pathophysiology?

Answer 3

Upper airway muscles relax during sleep

OSA = excessive narrowing of pharynx

Question 4

What can cause a small pharyngeal size?

Answer 4

Fatty infiltration of pharyngeal tissues
External pressure from increased neck fat
Large tonsils
Craniofacial abnormalities

Question 5

What is the effect of OSA?

Answer 5

Snoring 
Interrupted sleep 
Excessive daytime sleepiness
Nocturia 
GORD

Question 6

What is the Epworth sleepiness scale?

Answer 6

Used to assess daytime sleepiness

Scores

• 0 = would never doze
• 1 = slight chance
• 2 = moderate chance
• 3 = high chance

Scenarios

• sitting and reading
• watching TV
• sitting in public place
• passenger in car for an hoir
• lying down to rest in afternoon
• sitting and talking
• sitting after lunch with no alcohol
• in car while stopped in traffic

0-5 Lower Normal Daytime Sleepiness
6-10 Higher Normal Daytime Sleepiness
11-12 Mild Excessive Daytime Sleepiness
13-15 Moderate Excessive Daytime Sleepiness
16-24 Severe Excessive Daytime Sleepiness

Question 7

How is OSA diagnosed?

Answer 7

Sleep studies

• overnight oximetry
• snoring
• body movements
• HR

Question 8

How is OSA managed?

Answer 8

Weight loss
Mandibular advancement devices
Nasal CPAP

Question 9

What is the driving advice for OSA?

Answer 9

Do not drive while sleeping

Alert DVLA of diagnosis