Obstructive Sleep Apnoea

Question 1

What causes obstructive sleep apnoea?

Answer 1

Collapse of the pharyngeal airway during sleep

Question 2

How is it characterised?

Answer 2

Apnoea episodes during sleep where the person will stop breathing periodically for up to a few minutes.

This is usually reported by the partner as the patient is unaware of these episodes.

Question 3

Risk factors

Answer 3

Middle age
Male
Obesity
Alcohol
Smoking

Question 4

Features

Answer 4

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 5

Features in severe case

Answer 5

Hypertension
Heart failure
Increase the risk of myocardial infarction & stroke

Question 6

Epworth Sleepiness Scale results interpretation

Answer 6

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 7

Management

Answer 7

Referral to an ENT specialist or a specialist sleep clinic

Correct reversible risk factors by advising them to stop drinking alcohol, stop smoking and lose weight.

Continuous positive airway pressure (CPAP) machine that provides continuous pressure to maintain the patency of the airway.

Question 8

Gold standard treatment

Answer 8

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

Question 9

OSA Severity Scale

Answer 9

Normal - 0-5 desats per hour
Mild - 5-15 desats per hour
Moderate - 15-30 desasts per hour
Severe >30 desats per hour