Obstructive Sleep Apnoea

Question 1

what is obstructive sleep apnoea

Answer 1

a disease characterised by intermittent prolapse of the pharyngeal airway (upper airway) and apnoea (cessation of airflow for > 10 s) during sleep, followed by arousal from sleep

Question 2

what causes obstructive sleep apnoea

Answer 2

Occurs due to narrowing of the upper airways because of the collapse of soft tissues of the pharynx

This is due to decreased tone of the pharyngeal dilators during sleep

Question 3

what diseases/ abnormalities can cause obstructive sleep apnoea

Answer 3

Associated with:
Weight gain , Smoking , Alcohol, Sedative use, Enlarged tonsils and adenoids in children, Macroglossia, Marfan’s syndrome, Craniofacial abnormalities

Question 4

is obstructive sleep apnoea common

Answer 4

YES

prevelance increases with age

Question 5

what are the presenting symptoms of obstructive sleep apnoea

Answer 5

excessive daytime sleepiness, unrefreshing sleep, morning headaches, dry mouth, difficulty concentrating, snoring, nocturnal chocking/ nocturnal apnoeic episodes, irritability

Question 6

what signs will be present of obstructive sleep apnoea on

Answer 6

macroglossia, enlarged tonsils, pulled back jaws (retrognathia), increased neck circumference, obesity and hypertension

Question 7

what investigations will be done

Answer 7

Polysomnography is the traditional gold standard investigation. Physiological parameters are measured while the patient is asleep overnight (SLEEP STUDY)

Blood pressure

Question 8

management of obstructive sleep apnoea

Answer 8

Weight loss

Smoking cessation

Alcohol avoidance in the evening (sedative effect)

CPAP (Continuous positive airway pressure) maintains upper airway patency and is the gold standard

Question 9

what are some complications of obstructive sleep apnoea

Answer 9

Accidents related to excessive daytime sleepiness

Cardiovascular complications such as hypertension

Psychological consequences

Association with other cardiovascular comorbidities such as coronary artery disease, myocardial infarction, stroke and type 2 diabetes

Associated with increase in all cause mortality

Question 10

prognosis

Answer 10

Patients efficiently treated may report improvements in alertness and some improvement in quality of life, mood, and cognitive function