Obstructive Sleep Apnoea

Question 1

Define Obstructive Sleep Apnoea

Answer 1

Intermittent closure/collapse of the pharyngeal airway causing apnoeic episodes during sleep. Terminated by partial arousal.
Can cause pulmonary HTN and T2RF

Question 2

Aetiology of Obstructive Sleep Apnoea

Answer 2

?Heritable
Episodes are caused by dynamic narrowing of the upper airway during sleep
May be triggered by neuromuscular mechanisms in an anatomically small upper airway

Obesity -> lateral pharyngeal, soft palatial and tongue tissue mass increases -> narrow airway

Question 3

Risk factors for Obstructive Sleep Apnoea

Answer 3

Obesity
Male
Post-menopause
Large neck circumference

Question 4

Symptoms of Obstructive Sleep Apnoea

Answer 4

Loud snoring 
Gasping during sleep
Apnoeic episodes: episodic cessation of breathing terminated by loud snore
Daytime somnolence
Poor sleep quality 
Morning headache
Decreased libido 
Nocturnal 
Reduced cognitive performance

Question 5

Signs of Obstructive Sleep Apnoea on examination

Answer 5

Maxillomandibular anomalies

Macroglossia

Question 6

Investigations for Obstructive Sleep Apnoea

Answer 6

Scoring via Epworth score
Assess video recording

Pulse oximetry
Polysomnography (PSG): monitors O2 sats airflow at the mouth, ECG, EMG chest and abdominal wall movement . 15 or moe episodes of apnoea or hypopnoea during 1 hour of sleep on average indicates significant OSA