Obstructive Sleep Apnoea Flashcards
What is obstructive sleep apnoea (OSA)?
It is defined as a sleep disorder in which there are recurrent episodes of upper airway obstruction during sleep
It is characterised by apnoea episodes, in which the patient stops breathing periodically for up to a few minutes
Which part of the upper airway is obstructed in obstructive sleep apnoea?
Pharynx
How is obstructive sleep apnoea classified?
It is based upon the number of apnoea episodes that occur per hour
What is mild obstructive sleep apnoea?
5 – 15 apnoea episodes per hour
What is moderate obstructive sleep apnoea?
15 – 30 apnoea episodes per hour
What is severe obstructive sleep apnoea?
> 30 apnoea episodes per hour
What are the six risk factors associated with obstructive sleep apnoea?
Male Gender
Middle Aged
Obesity
Alcoholism
Smoking
Down’s Syndrome
What are the seven clinical features of obstructive sleep apnoea?
Apnoea Episodes
Habitual Snoring
Restless Sleep
Morning Headache
Daytime Somnolence
Concentration Issues
Hypertension
What is habitual snoring?
It is defined as loud snoring which occurs at least 3 nights per week
What are the three investigations used to diagnose obstructive sleep apnoea?
Epworth Sleepiness Scale
Overnight Pulse Oximetry
Polysomnography
What is the Epworth sleepiness scale?
It is a questionnaire used to determine whether the patient is experiencing excessive somnolence
It involves patients scoring their risk of falling asleep in various situations
What is an overnight pulse oximetry?
It measures the oxygen saturations during sleep
What is a sign of obstructive sleep apnoea on an overnight pulse oximetry?
There is reduced oxygen saturations during sleep
What is a sign of severe obstructive sleep apnoea on an overnight pulse oximetry?
Saw tooth pattern
What is the gold standard investigation used to diagnose obstructive sleep apnoea?
Polysomnography
What is polysomnography?
It involves measuring several functions during sleep, including…
- Brain activity (EEG)
- Muscle activity (EMG)
- Respiratory activity (pulse oximetry, airway capnography)
How many apnoea episodes indicate a diagnosis of obstructive sleep apnoea, in the absence of clinical features?
> 15 / hr
How many apnoea episodes indicate a diagnosis of obstructive sleep apnoea, in the presence of clinical features?
> 5 / hr
What is the first line management option used in obstructive sleep apnoea?
Conservative management
What is the conservative management of obstructive sleep apnoea?
It involves advising patients how they can correct reversible risk factors
In what four ways can individuals correct reversible risk factors of sleep apnoea?
Weight Loss
Smoking Cessation
Alcohol Cessation
Sleeping In Lateral Position
How are oral appliances used to manage obstructive sleep apnoea?
They are used to reduce upper airway collapsibility by widening the upper airway
What two oral appliances can be used to manage sleep apnoea?
Mandibular advancement devices
Tongue retaining devices
What is the second line management option of moderate to severe obstructive sleep apnoea?
CPAP
What does CPAP stand for?
Continuous positive airway pressure
What is CPAP ventilation?
It provides continuous pressure to maintain patency of the airways
What is the gold standard management option for severe obstructive sleep apnoea?
CPAP
What surgery is used to manage obstructive sleep apnoea?
Uvulopalaptopharyngoplasty (UPPP)
What is UPPP?
It is a procedure that involves surgical restructuring of the soft palate and the jaw to widen the upper airway
What are the five complications of obstructive sleep apnoea?
Diabetes
Hypertension
Heart Failure
Myocardial Infarction
Stroke
