Obstructive Sleep Apnoea

Question 1

What is OSA?

Answer 1

Muscles that support the soft tissues in your throat temporarily relax.

When these muscles relax, your airway is narrowed or closed, and breathing is momentarily cut off.

Question 2

Risk factors

Answer 2

Middle age
Male
Obesity
Alcohol
Smoking

Question 3

Features

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

Question 4

Features of severe cases of OSA

Answer 4

Hypertension
Heart failure.
Increase risk of MI and stroke

Question 5

Epworth Sleepiness Scale results

Answer 5

0-5 lower normal daytime sleepiness
 6-10 normal daytime sleepiness
11-12 mild excessive daytime symptoms
13-15 moderate excessive daytime symptoms
16-24 severe excessive daytime symptoms

Question 6

Management

Answer 6

Refer ENT specialist or a specialist sleep clinic where they can perform sleep studies.

The first step in management is to correct reversible risk factors by advising them to stop drinking alcohol, stop smoking and lose weight.

The next step is to use a continuous positive airway pressure (CPAP) machine that provides continuous pressure to maintain the patency of the airway.

Surgery is another option. This involves quite significant surgical restructuring of the soft palate and jaw. The most common procedure is called uvulopalatopharyngoplasty (UPPP).