Obstructive Sleep Apnea

Question 1

Define obstructive sleep apnea.

Answer 1

Repeated episodes of prolonged upper airway obstruction during sleep despite continued or increased respiratory effort, resulting in complete or partial cessation of airflow and disrupted sleep.

Question 2

What are possible long-term complications of untreated OSA?

Answer 2

Hypertension, pulmonary hypertension, arrhythmias, and heart failure.

Question 3

List some anatomic, physiologic, and metabolic abnormalities that can predispose to OSA.

Answer 3

Nasal (choanal stenosis/atresia, deviated septum, rhinitis, polyps), oropharyngeal (adenotonsillar enlargement, macroglossia, cleft palate repair, masses), craniofacial (micrognathia, trisomy 21, Pierre Robin sequence, achondroplasia), neuromuscular conditions (muscular dystrophies, hypotonic cerebral palsy, other hypotonias), and metabolic (obesity, hypothyroidism).

Question 4

What are some risk factors for OSA?

Answer 4

Increased weight, anatomic abnormalities, and poor pharyngeal or laryngeal tone.

Question 5

List 6 nocturnal symptoms of OSA.

Answer 5

Loud, frequent, disruptive snoring; breathing pauses; choking or gasping arousals; restless sleep; nocturnal diaphoresis; partial arousal parasomnias (sleepwalking, night terrors).

Question 6

List 8 daytime symptoms of OSA.

Answer 6

Daytime sleepiness/drowsiness, mouth breathing/dry mouth, chronic nasal congestion or rhinorrhea, hyponasal speech, morning headaches, poor appetite, difficulty with morning awakening, and poor academic performance.

Question 7

List 5 mood changes associated with OSA.

Answer 7

Irritability, mood instability, frustration, depression, and anxiety.

Question 8

What diagnosis shares many of the same signs and symptoms as OSA in children?

Answer 8

ADHD

Question 9

How is OSA diagnosed?

Answer 9

The gold standard for diagnosis is an overnight polysomnogram.