6- Upper airway - OSA - OSA, Presentation, Aetiology

Question 1

2 things that may be confused with OSA

Answer 1

simple snoring - no impact on sleep pattern or daytime sleepiness

upper airway resistance syndrome - UARS - sleep disruption and daytime sleepiness, WITHOUT desaturations/apnoea

Question 2

what is OSAHS

Answer 2

obstructive sleep apnoea hypopnea syndrome - sleep disruption and daytime sleepiness - WITH apnoa + desaturations

Question 3

triad of presentation

Answer 3

snoring, choking during sleep, apnoea (can be witnessed)

Question 4

consequences of OSA

Answer 4

daytime sleepiness, un-refreshed after sleep
impaired concentration
irritability
decreased libido

Question 5

Adult features of OSA

Answer 5

increases witha ge, more common in MALES, OBESE
1 Sx - daytime sleepiness,
cog impairment and impaired concentration

Question 6

Child features of OSA

Answer 6

2-5y = peak
M=F
failure to thrive, hyperactivity, developmental delay

Question 7

different severity’s for OSAHS

Answer 7

mild - 5-14 events/hr
mod - 15-30 events/hr
sev - >30 events/hr

Question 8

physical mechanism behind OSA

Answer 8

no cartilagenous support for airway from nasopharynx to larynx - relies on muscle tone for patency

• muscle tone decreased in sleep

Question 9

6 factors behind OSA

Answer 9

age, sex, obesity, social, FH, anatomical

Question 10

What other 5 things can cause/worsen OSA

Answer 10

hypothyroidism, acromegaly
drugs - opioids hypnotics
chronic lung disease- worsens impact

Question 11

how does sex affect risk? what about obesity? what about social history?

Answer 11

2-5x risk in men, decreased risk in post menopause women

obesity is the MAIN FACTOR - social - smoking and alcohol increase risk