Obstructive Sleep Apnoea

Question 1

What is obstructive sleep apnoea?

Answer 1

This is recurrent episodes of partial or complete upper pharyngeal obstruction during sleep, intermittent hypoxia and sleep fragmentation

Question 2

In obstructive sleep apnoea the airway collapses during sleep. T/F?

Answer 2

True

Question 3

What percentage of adults have undiagnosed obstructive sleep apnoea?

Answer 3

5%

Question 4

At what age does obstructive sleep apnoea present?

Answer 4

40-50 years

Question 5

Why is the incidence of obstructive sleep apnoea increasing?

Answer 5

Because of an increase in obesity

Question 6

What are the symptoms of obstructive sleep apnoea?

Answer 6

Snoring
Witnessed apnoeas
Disrupted sleep - choking, dry mouth, sweating
Unrefreshing sleep
Daytime somnolence
Fatigue
Low mood
Poor concentration

Question 7

What features should be examined in obstructive sleep apnoea?

Answer 7

Weight, BMI, BP, neck circumference, craniofacial appearance, tonsils and nasal latency

Question 8

What scoring systems can be used to assess excessive daytime sleepiness in obstructive sleep apnoea?

Answer 8

Epworth sleepiness score
STOP-BANG questionnaire
Berlin questionnaire

Question 9

What is measured in a limited polysomnography study?

Answer 9

Oxygen saturations
Heart rate
Flow
Thorax and Abdominal effort
Position during sleep

Question 10

What is measured in a full polusomnography?

Answer 10

ECG for sleep staging
Video and audio
Oxygen saturations
Heart rate
Flow
thorax and abdominal effort
Position during sleep

Question 11

How is apnoea defined in a sleep study?

Answer 11

Cessation or near cessation of airflow with 4% decrease in oxygen desaturation lasting >10 seconds

Question 12

How is hypopnea defined in a sleep study?

Answer 12

Reduction of airflow to a degree insufficient to meet the criteria for an apnoea.

Question 13

What are respiratory effort related arousals?

Answer 13

Arousals associated with a change in airflow that does not meet the criteria for apnoea or hypopnea

Question 14

What is the apnoea-hypopnea index?

Answer 14

Calculated number of apnoeas and hypopneas divided by the total sleep time in hours

Question 15

What is the oxygen desaturation index in sleep studies?

Answer 15

Number of times per hour of sleep that the SpO2 falls by 4% or more from baseline.

Question 16

An apnoea hypopnea index of what level is diagnostic of obstructive sleep apnoea?

Answer 16

> 15

Question 17

An apnoea hypopnea index of what level indicates mild obstructive sleep apnoea?

Answer 17

5-15

Question 18

An apnoea hypopnea index of what level indicates moderate obstructive sleep apnoea?

Answer 18

16-30

Question 19

An apnoea hypopnea index of what level indicates severe obstructive sleep apnoea?

Answer 19

> 30

Question 20

What lifestyle factors should be addressed in obstructive sleep apnoea?

Answer 20

Weight loss

Avoidance of triggering factors such as alcohol

Question 21

Describe CPAP?

Answer 21

CPAP splints the airway open, stops snoring, stops sleep fragmentation and improves daytime sleepiness. The patient can have just a nasal mask or a full face mask.

Question 22

If CPAP is not tolerated in mild-moderate obstructive sleep apnoea, what can be used instead?

Answer 22

Mandibular advancement device

Question 23

How long does it take for sleep position trains to change sleeping position?

Answer 23

Weeks

Question 24

What are the complications of untreated obstructive sleep apnoea syndrome?

Answer 24

Hypertension
Right heart strain
Cardiovascular disease
Increased accidents at work
Poor concentrations
Increased road traffic accidents

Question 25

The DVLA needs to be informed about obstructive sleep apnoea syndrome. T/F?

Answer 25

True

Question 26

What conditions do patients with obstructive sleep apnoea syndrome need to meet to retain their driver’s license?

Answer 26

Compliant with treatment

Reduced daytime symptoms