Obstructive Sleep Apnoea

Question 1

def

Answer 1

recurrent collapse of the pharyngeal airway & apnoea (cessation of airflow for >10s) during sleep, followed by arousal from sleep

Question 2

aetiology

Answer 2

obstructive apnoeas occur when upper airway narrows due to collapse of soft tissues of the pharynx when tone in pharangeal dilators decreases during sleep
associated with
1 excessive weight, smoking, alcohol or sedative use
2 enlarged tonsils or adenoids in children
3 macroglossia, Marfan’s syndrome

Question 3

what are adenoids

Answer 3

mass of enlarged lymphatic tissue between the back of the nose & throat which hinders speaking & breathing in young children

Question 4

epi

Answer 4

common
more common in males over 35
prevalence increases with age

Question 5

history

Answer 5

excessive daytime sleepiness
poor quality of sleep
difficulty concentrating & irritability
morning headaches or dry mouth
partner may report snoring, nocturnal apnoeic episodes, nocturnal choking

Question 6

examination

Answer 6

large tongue, enlarged tonsils
retrognathia (pulled back jaws)
neck circumference, >42cm in males, >40cm in females
obesity & HTN

Question 7

investigations

Answer 7

recording of episodes
sleep studies which monitor airflow, respiratory effect, pulse oximetry, heart rate
bloods (TFTs, ABG)