Sleep apnoea Flashcards Preview

Cardio-Resp > Sleep apnoea > Flashcards

Flashcards in Sleep apnoea Deck (6)
Loading flashcards...
1

Define obstructive sleep apnoea

Upper airway narrowing that is provoked by sleep. This causes sleep deprivation with consequent daytime sleepiness and impaired intellectual performance.

2

Explain the aetiology of obstructive sleep apnoea

Excessive narrowing with relaxation during sleep:
-Obesity
-Neuromuscular: stroke, MND, myotonic dystrophy
-Sedatives, alcohol, opioids
-Increasing age

Normal narrowing of a small pharynx during sleep:
-Fatty infiltration
-Increased neck fat and/or muscle bulk
-Large tonsils
-Craniofacial abnormalities, rhinitis, polyps

3

Describe the presentation of obstructive sleep apnoea

Snoring and apnoea attacks often witness by partner
Excessive daytime sleepiness (Epworth >9)
Impaired intellectual performance
Hypoxia and hypercapnia: corrected on arousal
Raised BP following arousal and in daytime
Nocturia

Less common: nocturnal sweating, reduced libido, reflux

4

How is obstructive sleep apnoea diagnosed?

Co-lateral history from relatives/partners
Epworth sleepiness scale: discriminate from snoring
Overnight pulse oximetry: sawtooth appearance

Sleep studies: primarily for research

Diagnosis confirmed if 10-15 or more apnoeas or hyponoeas in any 1 hour of sleep

5

Outline the management of obstructive sleep apnoea

Treatment based on symptoms and QoL
Treat modifiable factors: obesity, acromegaly, nasal polyps etc.

Lifestyle: Weight loss, sleep on side, avoid alcohol and caffeine in evenings.

Snorers/mild OSA: mandibular advancement device

Significant OSA: nasal CPAP, consider bariatric surgery (gastric band, gastric bypass, sleeve gastrectomy)

Severe OSA and hypercapnia: CPAP +/- NIV

6

What is the DVLA advice for obstructive sleep apnoea?

Patients must not drive whilst sleepy
Stop and have a nap
Must notify DVLA on diagnosis
Doctor can advise to stop driving