Obstructive Sleep Apnoea

Question 1

Define

Answer 1

A disease characterised by recurrent prolapse of the pharyngeal airway and apnoea (cessation of airflow for > 10 s) during sleep, followed by arousal from sleep.

Also known as Pickwickian Syndrome

Question 2

Cause

Answer 2

• Occurs due to narrowing of the upper airways because of the collapse of soft tissues of the pharynx
• This is due to decreased tone of the pharyngeal dilators during sleep

Question 3

Risk factors

Answer 3

Associated with:

Weight gain

Smoking

Alcohol

Sedative use

Enlarged tonsils and adenoids in children

Macroglossia

Marfan’s syndrome

Craniofacial abnormalities

Question 4

Epidemiology

Answer 4

COMMON

5-20% of men > 35 yrs

2-5% of women > 35 yrs

Prevalence increases with age

Question 5

Symptoms

Answer 5

• Excessive daytime sleepiness
• Unrefreshing or restless sleep
• Morning headaches
• Dry mouth
• Difficulty concentration
• Irritability and mood changes
• Partner reporting snoring, nocturnal apnoeic episodes or nocturnal choking

Question 6

Signs

Answer 6

Large tongue

Enlarged tonsils

Long or thick uvula

Retrognathia (pulled back jaws)

Neck circumference

• More than 42 cm in males
• More than 40 cm in females

Obesity

Hypertension

Question 7

Investigations

Answer 7

Sleep Study

• Monitor airflow, respiratory effort, pulse oximetry and heart rate

Bloods

• TFTs
• ABG