Obstructive Sleep Apnoea

Question 1

Which scale is used to assess someone’s daytime sleepiness?

Answer 1

Epworth Sleepiness Scale

Question 2

What is OSA?

Answer 2

Intermittent upper airway collapse in sleep
Apnoeas (cessation of breathing) or hypopnoeas +/- hypoxaemia
Recurrent arousals/sleep fragmentation

Question 3

Name some risk factors for OSA?

Answer 3

enlarged tonsils/adenoids
obesity
maxillomandibular abnormalities
endocrine --> acromegaly, hypothyroidism, DM
male
neuro --> stroke, MS, myasthenia gravis, myotonic dystrophy
drugs --> benzos, opiates, alcohol
PCOS
metabolic syndrome

Question 4

What are the clinical features of OSA?

Answer 4

Excessive daytime sleepiness
Apnoea (episodic cessation of breathing followed by a loud snore)
Episodic gasping
Restless sleep
Chronic snoring
Risk of RTAs (falling asleep at wheel)

Question 5

What investigations would you do for OSA?

Answer 5

Snoring + high score on Epworth Sleepiness Scale

Polysomnography (overnight sleep study)

Question 6

What is the management of OSA in adults?

Answer 6

Remove underlying cause if possible - lifestyle advice

CPAP

Question 7

What is the 1st line management of OSA in children?

Answer 7

Adenotonsillectomy

Question 8

How is severity of OSA categorised following polysomnography?

Answer 8

Mild: 5-14 episodes per hour
Moderate: 15-30 episodes per hour
Severe: > 30 episodes per hour

Question 9

What are the risks associated with OSA?

Answer 9

Driving –> patient must inform DVLA
Significant increased CV risk
Long term effects on memory, cognitive function and mood