Obstructive Sleep Apnoea Syndrome

Question 1

Define Obstructive Sleep Apnoea Syndrome

Answer 1

Characterised by the intermittent closure/collapse of the pharyngeal airway causing episodes of apnoea during sleep

Question 2

Define Apnoea

Answer 2

Temporary cessation of breathing

Key characteristic of Obstructive Sleep Apnoea Syndrome

Question 3

How are apnoea episodes terminated

Answer 3

by partial arousal

Question 4

Name some of the risk factors for Obstructive Sleep Apnoea Syndrome

Answer 4

Obesity

Middle age

Male sex

Smoking

Alcohol excess

Macroglossia e.g. acromegaly, hypothyroidism, amyloidosis

NOTE: Typical patient is obese, middle aged male who present because of snoring or daytime somnolence.

Question 5

Name some of the clinical features of Obstructive Sleep Apnoea Syndrome

Answer 5

Typical patient is obese, middle aged male who present because of snoring or daytime somnolence.

Episodes of apnoea during sleep (reported by their partner)

Snoring

Daytime somnolence/sleepiness

Waking up unrefreshed from sleep

Irritability

Lack of concentration

Reduced oxygen saturations during sleep

Question 6

What can severe cases of Obstructive Sleep Apnoea Syndrome cause

Answer 6

Severe cases can cause: hypertension, heart failure and can increase the risk of myocardial infarction and stroke.

Question 7

What is the scoring tool used to assess symptoms of sleepiness associated with obstructive sleep apnoea

Answer 7

Epworth Sleepiness Scale

Question 8

What is the Epworth Sleepiness Scale

Answer 8

Scoring tool used to assess symptoms of sleepiness associated with obstructive sleep apnoea

Question 9

What is the gold standard investigation for Obstructive Sleep Apnoea Syndrome

Answer 9

Polysomnography (sleep studies)

Question 10

Patients will suspected Obstructive Sleep Apnoea Syndrome should be referred to which speciality

Answer 10

ENT for polysomnography (sleep studies)

Question 11

What are the 3 options of managing Obstructive Sleep Apnoea Syndrome

Answer 11

Lifestyle changes/limit risk factors

Continuous positive airway pressure (CPAP)

Intra-oral devices

Question 12

Name some of the lifestyle changes that can be used to manage Obstructive Sleep Apnoea Syndrome

Answer 12

Weight loss

Smoking cessation

Stop drinking alcohol

Question 13

What is used first line after lifestyle changes or for moderate-severe cases of Obstructive Sleep Apnoea Syndrome

Answer 13

Continuous positive airway pressure (CPAP)

Question 14

_____ positive airway pressure is used in managing Obstructive Sleep Apnoea Syndrome

a) Continuous
b) Bilevel

Answer 14

a) Continuous

Question 15

What device is used if CPAP is not tolerated or those with mild cases of Obstructive Sleep Apnoea Syndrome

Answer 15

Intra-oral devices e.g. mandibular advancement

Question 16

When should the DVLA be informed of Obstructive Sleep Apnoea Syndrome

Answer 16

If patient has excessive daytime sleepiness

Question 17

Name three potential complications of Obstructive Sleep Apnoea Syndrome

Answer 17

CV complications e.g. hypertension, stroke, heart failure, MI

Psychological consequences

Accidents related to the excess daytime sleepiness