Obstructive Sleep Apnoea Flashcards
What is first line for OSA?
CPAP (continuous positive airway pressure)
What is an alternative to CPAP?
Intracranial mandibular advancement device
What are the symptoms of OSA?
Unrefreshing sleep, or frequent waking at night
Daytime sleepiness
Others may witness snoring, apnoeas, gasping or choking during sleep
Nocturia
Difficulty concentrating
Morning headaches
Behavioural problems and hyperactivity in children
What is the definitive investigation for OSA?
Polysomnography, which is a sleep study for urgent referral with:
Excessive sleepiness is impacting on their safety to work (e.g. professional driver)
They have a related comorbid condition such as treatment resistant hypertension or COPD
They have upcoming major surgery
They are pregnant
They are given an apnoea-hypnosis index score
Whic surgery can be considered for OSA?
Tonsillectomy for adenotonsillar enlargement
What is the criteria for obstructive sleep apnoea
Apnoea-hypopnea score should be 5 events per hour.
How are patients managed with a AHI score less than 5 events per hour?
Conservative management:
If overweight, focus on weight loss
If smoking, focus on smoking cessation
Avoid sleeping SUPINE
Avoid alcohol in the evenings
What is the treatment for AHI score above 5?
Continuous positive airway pressre
What are the risk factors for OSA IN CHILDREN?
Adenotonsillar hypertrophy in children
Sleeping supine
Down’s syndrome
Decreased muscle tone
What is mild OSA?
5-14 events per hour
What is moderate OSA?
15-30 events per hour
What is severe OSA?
OVER 30 events per hour
Which complications can arise from OSA?
Storkecoronary artery disease
Congestive heart failure
Type 2 diabetes
What is the most appropriate initial management for OSA?
Lifestyle modification
