Obstructive Sleep Apnoea

Question 1

Aetiology of Obstructive Sleep Apnoea.

Answer 1

Collapse of the pharyngeal airway during sleep.

Question 2

Risk Factors of Obstructive Sleep Apnoea (5).

Answer 2

1. Middle Age.
2. Male.
3. Obesity.
4. Alcohol.
5. Smoking.
6. Macroglossia.
7. Large Tonsils.
8. Marfan’s Syndrome.

Question 3

Give 3 conditions that can cause macroglossia.

Answer 3

1. Acromegaly.
2. Hypothyroidism.
3. Amyloidosis.

Question 4

Clinical Presentation of Obstructive Sleep Apnoea.

Answer 4

1. Apnoea episodes during sleep where the person will stop breathing periodically for up to a few minutes (usually reported by partner).
2. Snoring.
3. Morning Headache.
4. Waking Up Unrefreshed.
5. Daytime Sleepiness.
6. Concentration Problems.
7. Reduced Oxygen Saturation during Sleep.

Question 5

How can Severe Obstructive Sleep Apnoea present?

Answer 5

1. Hypertension.
2. Heart Failure.
3. Increased Risk of MI and Stroke.

Question 6

What scoring system is used to assess Obstructive Sleep Apnoea?

Answer 6

Epworth Sleepiness Scale - assess symptoms of sleepiness.

Question 7

Investigations of Obstructive Sleep Apnoea (3).

Answer 7

1. Epworth Sleepiness Scale.
2. Multiple Sleep Latency Test (time taken to fall asleep in dark room).
3. Polysomnography : Sleep Studies.

Question 8

Management of Obstructive Sleep Apnoea (5).

Answer 8

1. Referral to ENT or Specialist Sleep Clinic : Sleep Studies.
2. Correct Reversible Risk Factors.
3. CPAP - Continuous Pressure to Maintain Patency of Airway.
4. Surgery : Uvulopalatopharyngoplasty (UPPP) - significant surgical restructuring of the soft palate and jaw.
5. DVLA Inform.

Question 9

What happens in a sleep study?

Answer 9

Measuring observations to establish any apnoea episodes and the extent of their snoring during sleep.