Obstructive Sleep Apnoea

Question 1

Obstructive sleep apnoea

Answer 1

Intermittent upper (pharyngeal) airway collapse in sleep terminated by partial arousal.

Question 2

What affect does OSA have on sleep?

Answer 2

Recurrent arousals/ sleep fragmentation

Question 3

Risk Factors

Answer 3

Enlarged tonsils, obesity, retrognathia, oropharyngeal deformity, neurological, drugs, post-op.

Question 4

Symptoms

Answer 4

Loud snoring, daytime somnolence, poor sleep quality, morning headache, decreased libido & cognitive function

Question 5

Investigations

Answer 5

Overnight sleep study

Question 6

Affect of sleep disturbance

Answer 6

Excessive daytime sleepiness, personality change, cognitive/functional impairment.

Question 7

Complications

Answer 7

Pulmonary hypertension ,Type II Resp failure, activated sympathetic system, impaired glucose tolerance, impaired endothelial function, probable cause of stroke & CV events.

Question 8

Treatment; Lifestyle changes

Answer 8

Weight reduction, smoking cessation, alcohol avoidance, CPAP via nasal mask during sleep.

Question 9

Treatment: Surgery

Answer 9

To release pharyngeal obstruction/advance mandible.

Question 10

Treatment: Continuous positive airway pressure

Answer 10

Improves consequences of sleep apnoea, ensures airway is patent.

Question 11

Treatment: Mandibular Advancement Device

Answer 11

Improves snoring, used in mild OSA