2: OSA Flashcards
What is obstructive sleep apnea
Condition characterised by intermittent and recurrent collapse of small airways during sleep
What is the criteria to diagnose obstructive sleep apnea
- More than 5 episodes per-hour characterised by polysonography
- Symptoms of OSA
In an adult what are 5 risk factors for OSA
Obesity Male Middle-Age Smoking Alcohol Sedative-use
In children what are 2 risk factors for OSA
Enlarged Tonsils
Enlarged adenoids
In an adult, what are the 4 symptoms of OSA
- Daytime sleepiness
- Poor concentration
- Morning headaches
- Episodes observed by
partner
What scale is used to assess daytime sleepiness
Epworth Sleepiness Scale
What is an abnormal score on Epworth Daytime Sleepiness Scale
> 10
What is mild epworth daytime sleepiness
11-14
What is moderate epworth daytime sleepiness
15-18
What is severe epworth daytime sleepiness
> 18
In children, how may OSA present
- Snoring
- Sleep disturbance
- Enuresis
- Daytime sleepiness
- Mouth breathing which can lead to cracked lips
What symptoms may enlarged adenoids
Recurrent otitis media. Or chronic otitis media with effusion.
What is first-line investigation for OSA
Polysomnography
What does polysomnography detect
Brain waves HR Oxygen Leg movements Eye movements
= all during sleep
how is OSA scaled on polysomnography
Apnea-Hypoapnea index
What is first-line management of OSA in adults
Lifestyle changes:
- Weight Loss
- Smoking cessation
- Reduce alcohol
What is second-line management of OSA in adults
CPAP
What is the role of CPAP in OSA
Positive pressure prevents airways from collapsing
What is the problem with CPAP
Poor compliance
What surgical management may be offered for OSA
Uvulopalatopharyngoplasty (UPPP)
In children what may be used to manage OSA
Adenoidectomy
What are the indications of adenoidectomy in children
- OSA
- Recurrent otitis media
- Recurrent nasopharyngitis
- Chronic mouth breathing
What is the risk with obstructive sleep apnea
Increase risk of:
- HTN
- Cardiac morbidity
- Stroke
What should all patients with OSA have calculated and why
QRISK2 - enable RF modification due to increased risk of cardiac morbidity.