Obstructive Sleep Apnoea

Question 1

what is the pathophysiology of OSA?

Answer 1

collapse of the pharyngeal airway during sleep

apnoea episodes during sleep (pt stops breathing periodically for a few minutes)

Question 2

what are the risk factors for OSA?

Answer 2

Middle age
Male
Obesity
Alcohol
Smoking

Question 3

symptoms of OSA

Answer 3

Apnoea episodes during sleep (reported by partner)
Snoring
Morning headache
Waking up unrefreshed from sleep
Daytime sleepiness
Concentration problems
Reduced oxygen saturation during sleep

*if severe can cause HTN, HF, MI, stroke

Question 4

Epworth sleepiness scale

Answer 4

used to assess symptoms of sleepiness associated with OSA

*important to ask about occupation e.g. HGV driver requires immediate referral and amended duties whilst waiting assessment and treatment

Question 5

management of OSA

Answer 5

referral to ENT
specialist sleep clinic (sleep studies) (monitor HR, O2 sats, RR an breathing to establish any apnoea episodes)

1. correct reversible RF alcohol, stop smoking, weight loss)
2. CPAP (keep potency of airway)
3. surgery (restructure the soft palate and jaw. uvulopalatopharyngoplasty (UPPP)