Obstructive Sleep Apnoea

Question 1

Pathophysiology

Answer 1

Narrowing of upper airway size, provoked by sleep, causing daytime symptoms.

Question 2

Symptoms

Answer 2

Daytime Sleepiness
Apnoea attacks
Nocturia
Loss of libido
Reflux

Question 3

Signs

Answer 3

Hypoxia
Hypercapnia
Increased BP (Day and night)

Question 4

Typical patient

Answer 4

Obese male with small, set back mandible.

Question 5

Causes

Answer 5

1. Small pharyngeal opening - Neck fat, Craniofacial abnormality, Large tonsils.
   2.Excessive narrowing at night - Alcohol, age, Obseity, Neuromsucular disorder.

Question 6

Management

Answer 6

Weight loss, Avoid alcohol before bed, Sleep on side
Mandible support, Pharyngeal surgery
Nasal CPAP, Tracheostomy
NIV if acidotic

Do not drive if sleepy, inform DVLA if indicated.

Question 7

Investigations

Answer 7

1. Overnight Oximetry
2. Limited sleep study
3. Full polysomnogrophy

Question 8

Epworth Sleep Scale

Answer 8

Likelohood to doze off while conducting different activities