Obstructive sleep apnoea Flashcards
Define obstructive sleep apnoea
A disease characterised by recurrent prolapse of the pharngeal airway and apnoea (cessation of airflow for >10s) during sleep, followed by arousal from sleep. Also known as Pickwickian syndrome
Explain the aetiology/risk factors of obstructive sleep apnoea
Occurs due to narrowing of the upper airways because of the collapse of soft tissues of the pharnx
This is due to decreased tone of the pharyngeal dilators during sleep
Associated with:
- Weight gain
- Smoking
- Alcohol
- Sedative use
- Enlarged tonsils and adenoids in children
- Macroglossia
- Marfan’s syndrome
- Craniofacial abnormalities
Summary the epidemiology of obstructive sleep apnoea
- Common 5-20% of men >35 years
- 2-5% of women >35 years
- Prevalence increases with age
Recognise the presenting symptoms of obstructive sleep apnoea
- Excessive daytime sleepiness
- Unrefreshing or restless sleep
- Morning headaches
- Dry mouth
- Difficulty concentrating
- Irritability and mood changes
- Partner reporting snoring, noctural apnoeic episodes or noctural choking
Recognise the signs of obstructive sleep apnoea on physical examination
- Large tongue
- Enlarged tonsils
- Long or thick uvula
- Retrognathia (pulled back jaws)
- Neck circumference
- More than 42cm or 40cm in males and females respectively
- Obesity
- Hypertension
Identify appropriate investigations for obstructive sleep apnoea
- Sleep study
- Monitor airflow, respiratory effort, pulse oximetry and heart
- Bloods: TFTs ABG