Obstructive Sleep Apnoea (Obstructive Airway Disease)

Question 1

What is obstructive sleep apnoea?

Answer 1

Intermittent closure and collapse of the pharyngeal airways during sleep. This closure results in episodes of apnoea, which are terminated by partial arousal.

Question 2

What are some risk factors for obstructive sleep apnoea?

Answer 2

• Obesity
• Endocrine diseases (e.g. acromegaly, hypothyroidism)
• Drugs (e.g. benzodiazepines, opiates, alcohol)
• ENT diseases (e.g. enlarged tonsils or adenoids, oropharyngeal deformity)
• Neurological diseases (e.g. stroke, MS, myasthenia, myotonic dystrophy)

Question 3

What is the general presentation of obstructive sleep apnoea?

Answer 3

• Loud snoring
• Poor quality sleep
• Morning headache
• Excessive daytime sleepiness
• Reduced cognitive function and major impact on daytime functioning

Question 4

What are the complications of obstructive sleep apnoea?

Answer 4

• Pulmonary hypertension
• Type 2 respiratory failure
• Increased risk of hypertension

Question 5

What investigations would be done for obstructive sleep apnoea?

Answer 5

An overnight sleep study (pulse oximetry, domiciliary recordings or full polysomnography)

Question 6

What overnight sleep study would be indicative of obstructive sleep apnoea?

Answer 6

Presence of > 15 episodes of apnoea during 1 hour of sleep

Question 7

What is the management of obstructive sleep apnoea?

Answer 7

• Weight loss
• Alcohol and tobacco avoidance
• CPAP at night
• Remove or treat any underlying cause
• Inform the DVLA of the diagnosis