Obstructive Sleep Apnoea

Question 1

What is obstructive sleep apnoea?

Answer 1

Intermittent and repeated upper airway collapse during sleep.

Question 2

What is the usual presentation of a patient with sleep apnoea?

Answer 2

Main symptom is daytime sleepiness and unrefreshing sleep.

May have witnessed snoring and apnoeas.

Question 3

What are the main risk factors for developing sleep apnoea?

Answer 3

Obesity is the strongest risk factor.

Other risk factors include:
Male
Smoking
Opioids
Alcohol
Sedatives
Large adenoids or tonsils

Question 4

How is suspected sleep apnoea investigated?

Answer 4

Using sleep studies.

Most commonly measure O2 saturations as apnoeas will correspond with desaturations.

There must be at least 5 apnoeas per hour for a diagnosis.

Question 5

What are the main treatment options in sleep apnoea?

Answer 5

Lifestyle changes: 
Let partner sleep before you
Sleep on side 
Lose weight
Quit smoking (may not benefit apnoeas)
Avoid drinking alcohol at night or other sedatives

CPAP:
Continuous positive airway pressure to ensure that the airway remains patent throughout.

If CPAP not tolerated then

• intra oral devices
• daytime stimulants
• upper airway surgery