Obstructive Sleep Apnoea

Question 1

Obstructive sleep apnoea hypopnea syndrome (OSAHS);

Interrupted & repeated ? of the ? airway during ??? sleep, associated with hypopnea / apnoea and ?
.
? leads to increasing respiratory effort until the patient overcomes the
resistance.

The combination of central
? and respiratory ? briefly wakes the patient, leading to excess ? sleepiness.

The patient is ? of the awakenings from sleep.

Answer 1

collapse
upper
REM
desaturations

hypoxia

hypoxia
effort
daytime

unaware

Question 2

Correctible factors include;

o Respiratory ?: ?, alcohol, ?.
o ? obstruction: ?, rhinitis, ?.
o Encroachment on the ?: obesity, ?.

Answer 2

depressants
opioids
sedatives
nasal
adenoids
polyps
pharynx
acromegaly

Question 3

Presenting complaints;

o ? during sleep.
o ? sleepiness.
o Morning ?.
o Decreased ?.
o Nocturnal ?.
o Witnessed ? episodes.

Answer 3

snoring
daytime
headaches
libido
choking
apnoeic

Question 4

Complications;

o Pulmonary ? & ? pulmonale.
o Type ? respiratory failure.
o ? and increased cardiac risk.

Answer 4

HTN
cor
2
HTN

Question 5

Investigations;

o ? sleepiness scale: to distinguish from ? snoring.

o ? examination of the ?airway by ENT.

o ? pulse oximetry: high false ? (30%), and also false
positives in patients with ?.

o ? : gold standard for diagnosis, with in-patient assessment of variable parameters (EEG, EMG, electro-oculogram,
respiratory ?, ?-abdominal movement, ECG, oximetry,
snoring ? and ?). -> • This is diagnostic but rarely used clinically - limited ?
? may be used instead.

Answer 5

Epsworth
simple

endoscopic
upper

home
negative
COPD

polysomnography
airflow

thoraco
sound and video
sleep studies

Question 6

Diagnosis is made with the occurrence of >? episodes of apnoea/ hypopnea
during ? ? of sleep.

Management;

0 Behavioural changes: allow partner to sleep ?, sleep on ?.

0 ? reduction.

0 Avoidance of ? and ?.

0 ???? via a ? mask: ?pressure keeps the ? open.

0 ?% will not tolerate CPAP, so alternatives include;
• ?-oral devices.
• Daytime stimulants: e.g. ?.
• Upper airways ?: if upper airways pressure assessments
can ? a level of ?.

Answer 6

15
one hour

first
side
weight
alc 
tobacco
CPAP
nasal
positive
pharynx
50
intra
modafinil
surgery
localize
obstruction