Obstructive sleep apnoea

Question 1

Define obstructive sleep apnoea

Answer 1

Disease characterised by recurrent prolapse of pharyngeal airway & apnoea during sleep, followed by arousal from sleep

Question 2

Define apnoea

Answer 2

cessation of airflow for > 10 secs

Question 3

Aetiology of obstructive sleep apnoea

2

Answer 3

Occurs due to narrowing of upper airways because of collapse of soft tissues of pharynx
Due to decreased tone of pharyngeal dilators during sleep

Question 4

Associations of obstructive sleep apnoea

8

Answer 4

Weight gain 
Smoking
Alcohol
Sedative use
Enlarged tonsils & adenoids in children
Macroglossia
Marfan’s syndrome
Craniofacial abnormalities

Question 5

Epidemiology of obstructive sleep apnoea

prevalencex4

Answer 5

COMMON
5-20% of men > 35 yrs
2-5% of women > 35 yrs
Prevalence increases w/ age

Question 6

Presenting symptoms of obstructive sleep apnoea

7

Answer 6

Excessive daytime sleepiness
Unrefreshing or restless sleep
Morning headaches
Dry mouth
Difficulty concentrating
Irritability & mood changes
Partner reported snoring, nocturnal apnoeic episodes or nocturnal choking

Question 7

Signs of obstructive sleep apnoea on physical examination

7

Answer 7

Large tongue
Enlarged tonsils
Long or thick uvula 
Retrognathia 
Neck circumference 
> 42cm in males
> 40cm in females
Obesity 
Hypertension

Question 8

Define retrognathia

Answer 8

pulled back jaw

Question 9

Investigations for obstructive sleep apnoea

2 types

Answer 9

Sleep study

Bloods

Question 10

Investigations for obstructive sleep apnoea - sleep study

Answer 10

Monitor airflow, respiratory effort, pulse oximetry & HR

Question 11

Investigations for obstructive sleep apnoea - bloods

2

Answer 11

TFTs

ABG