Obstructive Sleep Apnoea Flashcards
What is obstructive sleep apnoea?
When obstruction of airway during sleep occurs, due to relaxation of muscles of neck
Describe what happens in OSA
When you sleep muscles relax including those in throat. In some, this causes airway to narrow - makes you snore. If throat closes completely, you stop breathing for a time = apnoea
Brain will start you breathing again, some people wake up briefly, others not aware. Breathing often restarts with a gasp or grunt. Pattern repeats as muscles relax again.
What symptoms occur?
While asleep: Snoring Stopping breathing Feeling of choking Jerky body movements Needing to pass water in night
When awake: Tiredness Headache Difficulty concentrating Poor memory Changeable/ irritable mood Loss of libido
What risk factors are there?
Male Obesity Family history Craniofacial abnormalities Adenotonsillar hypertrophy
How is it diagnosed?
Epworth sleepiness scale - quantifying now symptoms are affecting day to day life
What investigations should be done?
BMI TFT - ? hypothyroidism ECG - ? signs of RVF CXR - ? Signs of obstructive lung disease Sleep study
(HF and lung complications can occur as a result of OSA)
What examinations should be done?
Look for nasal obstruction Examine jaw Look for enlarged tonsils (esp in children) Calculate BMI Measure neck circumference
How can the condition be definitively diagnosed?
A sleep study
What lifestyle changes can be made?
Weight loss Stop smoking Keep active Reduce alcohol Sleep on side Better sleep quality - wake up and go to bed same time every day, keep bedroom dark and quiet, eight hours per night
What treatment can be provided from sleep clinic?
Mandibular advancement devices - bring lower jaw forward
CPAP - stop collapse of airway
Is surgery an option?
If severely obese - bariatric surgery
Operations may be helpful in small number of cases e.g for people with enlarged tonsils, adenoids, nasal polyps
How does it affect driving?
Must inform DVLA if your diagnosed with OSA and feel excessively sleepy when drive
Repeated sleep apnoea can put a strain on…
Cardiovascular system
What is the commonest cause of OSA in children?
Adenotonsillar hypertrophy
What is the most common cause of OSA in adults?
Obesity
