snoring and OBA

Question 1

Snoring

Answer 1

Stertorous sound while asleep caused by turbulent airflow in the upper aerodigestive tract
Usually at level of soft palate, tonsils and tongue base

Question 2

OSA

Answer 2

Greater than 10 seconds of temporary cessation of breathing (apnoea) while sleeping
Caused by obstruction of airflow in the upper aerodigestive tract

can cause heart problems

Question 3

Central Sleep Apnoea

Answer 3

rare
lack of central drive rather than airway obstruction therefore snoring as a symptom is less common

Question 4

mild, moderate and severe OSA

Answer 4

Mild = 5 - 15 episodes per hour
Moderate = 15 - 30 episodes per hour
Severe = >30 episodes per hour

Question 5

Risk factors for Snoring & OSA

Answer 5

High BMI
Older Age
Physical/structural
Large tonsils +/- adenoids
Small mandible / retrognathia – e.g. Pierre Robin sequence, Goldenhaar Syndrome, Treacher Collins Syndrome
Macroglossia – e.g. Down’s Syndrome
Drugs
Alcohol
Benzodiazepines

Question 6

diagnosis of OSA

Answer 6

Neck Circumference

Epworth Sleepiness Score – daytime somnolence

oral cavity, nose and flexible nasal endoscopy to assess the level generating the snoring

thyroid function

Polysomnography

Limited sleep study includes recording pulse oximetry

Nasal & oral airflow
Chest circumference
Abdominal circumference

Question 7

management of snoring

Answer 7

devices- from the tongue base level the use of a mandibular advancement splint

surgical -tonsil and soft palate level, uvulopalatopharyngoplasty (UPPP), rare/ device to palate to stiffen radiofrequency probe to cause scarring

Question 8

OSA management

Answer 8

Devices
CPAP
Mandibular Advancement Splint

surgical- same as snoring

Question 9

snoring and OSA management in kids

Answer 9

snoring- commonly due to enlargement of tonsils and adenoids , if doesn’t go away then Adenotonsillectomy

OSA- Adenotonsillectomy