obstructive sleep apnoea

Question 1

definition

Answer 1

Characterized by recurrent collapse of the pharangeal airway and apnoea (defined as cessation of airflow for >10 s) during sleep, followed by arousal from sleep. Also known as Pickwickian syndrome.

Question 2

symptoms/history

Answer 2

• Excessive daytime sleepiness (at work, driving).
• Unrefreshing or restless sleep.
• Morning headaches or dry mouth, difficulty concentrating, irritability or mood changes.
• Partner reporting snoring, nocturnal apnoeic episodes or nocturnal choking.

Question 3

risk factors

Answer 3

. excessive weight gain, smoking, alcohol or sedative use;
. enlarged tonsils or adenoids in children; and
. macroglossia, Marfan’s syndrome, craniofacial abnormalities.

Question 4

examination

Answer 4

• Large tongue, enlarged tonsils, long or thick uvula, retrognathia (pulled back jaws).
• Neck circumference (>42 cm males, >40 cm females) is strongly correlated with presence of disease.
• Obesity and hypertension is common.

Question 5

investigations

Answer 5

• Video recording of episodes.
• Sleep study: Managed by sleep study centre for polysomnography or diagnostic sleep
  studies with monitoring of airflow, respiratory effort, pulse oximetry and heart rate.
• Blood: Thyroid function tests, ABG.