Obstructive Sleep Apnea

Question 1

What occurs in OSA? Why does it happen?

Answer 1

Intermittent closure or collapse of pharngeal airway which is terminated by partial arousal

Associated with relaxation of pharyngeal/throat muscles or compression of soft tissue due to increased body habitus seen in obese patients
-leads to decreased diameter of airway which leads to increased chance of airway obstruction by tongue when sleeping

Question 2

What features or problems might someone with OSA present with? Who else might be important to ask?

Answer 2

Important to ask partner for collateral history of what patient is like during sleep and during an episode of apnoea

Loud snoring 
Daytime somnolence 
Poor quality sleep 
Morning headache 
Decreased libido 
Nocturia
Decreased cognitive performance

Question 3

What are the complications which can occur due to OSA?

Answer 3

Pulmonary hypertension= due apnoea episodes causing hypoxia state which leads to induction of vasoactive substances

Type 2 respiratory failure= due to apnoea leading to alveolar hypoventilation

Increased risk of systemic hypertension

Question 4

How can obstructive sleep apnoea be diagnosed?

Answer 4

Pulse oximetry and videos can be enough for diagnosis
Can use polysomnography= diagnostic
Presence of 15(+) episodes of apnoea in night= OSA

Question 5

How can OSA be managed?

Answer 5

Weight loss
Smoking cessation
Decreasing alcohol consumption
CPAP for moderate to severe condition