ICL OSA - Week 1

Question 1

What part of the pharynx can block airway if too long in OSA?

Answer 1

Uvula.

Question 2

3 types of sleep apnoea

Answer 2

• Obstructive – occurs when throat muscles relax and block the flow of air into the lungs.
• Central – occurs when the brain doesn’t send proper signals to the muscles that control breathing.
• Complex – pt with OSA receives treatment which causes OSA to convert to CSA.

Question 3

Sleep events

Answer 3

Apneas: breathing stops & starts
Hypopneas: reduction in ventilation at least 50% leading to obstruction
RERA (Respiratory Effort Related Arousal): causes pt to wake up when asleep.

Question 4

How many sleep events must occur per hour for Dx of OSA?

Answer 4

5.

Question 5

Risk factors OSA

Answer 5

• Male
• Age (over 50 years)
• Overweight & neck circumference
• Type 2 diabetes
• Excess alcohol consumption
• Sedative medications
• Opiods
• Smoking
• Sleeping supine
• Tonsillar hypertrophy
• Nasal obstruction
• Thyroid disease
• Neuromuscular disease
• Insomnia
• FHx incl. genetic factors related to jaw morphology
• Post-menopause

Question 6

Co-morbidities of OSA

Answer 6

• Hypertension
• Mood disorders
• Depression
• Cognitive dysfunction
• Coronary artery disease
• Heart failure
• Atrial fibrillation
• Cerebrovascular accident (CVA)
• Type 2 Diabetes mellitus
• Insomnia
• Liver scarring

Question 7

OSA symptoms:

Answer 7

• During the day: Excessive daytime sleepiness, difficulty concentrating, mood changes, depression, irritability, decreased libido
• At night: Loud snoring, observed episodes of stopped breathing during sleep, abrupt awakenings accompanied by gasping or choking, night sweats, restlessness
• Morning: Awakening with a dry mouth or sore throat, headache, waking up unrefreshed

Question 8

Lifestyle changes for OSA

Answer 8

• Reducing alcohol, nicotine & sedative consumption
• Weight loss
• Sleep hygiene – consistent sleep routine, restrict in-bed activities, physical activity