Sleep Disorders

Question 1

What are the cardinal features of obstructive sleep apnoea? What are some other symptoms?

Answer 1

• Heavy snoring
• Daytime somnolence
• Witnessed apnoeas
• Poor sleep quality
• Nocturnal choking/gasping
• Nocturia
• Headaches
• Memory/cognition defects
• Depression
• Sexual dysfunction
• Uncontrolled hypertension

Question 2

What is central sleep apnoea? What can cause it?

Answer 2

• Reduction in central respiratory drive
• Causes
  
  • Cardiac failure (Cheyne-Stokes respiration)
  • High altitude
  • CNS disorders

Question 3

What is narcolepsy? What are some common symptoms?

Answer 3

• Intrusion of REM sleep into wakefulness
• Causes - orexin deficiency (autosomal dominant), begins in teens/twenties
• Symptoms
  
  • Excessive daytime sleepiness/waking naps
  • Hypnagogic hallucinations
  • Sleep paralysis, 1-2 mins after waking
  • Cataplexy (collapse on strong emotion or laughter) - common (60%)

Question 4

How might you manage someone with narcolepsy?

Answer 4

• Trigger avoidance, strategic naps, career counselling
• Stimulants (modafinil, amphetamines), SSRIs, tricyclics