Obstructive Sleep Apnoea Syndrome (OSAS)

Question 1

Obstructive Sleep Apnoea Syndrome: Define

Answer 1

Obstructive Sleep Apnoea Syndrome is when you stop breathing while sleeping - with short bursts of awakening to breathe again.

Question 2

Obstructive Sleep Apnoea Syndrome: Causes

Answer 2

Narrow Pharynx
Obesity
Muscle Relaxation

Question 3

Obstructive Sleep Apnoea Syndrome: Risk Factors

Answer 3

Obesity
Large Tonsils
Macroglossia (Acromegaly, hypothyroidism, amyloidosis)
Marfans Syndrome

Question 4

Obstructive Sleep Apnoea Syndrome: Complications

Answer 4

Hypertension
Increased risk of Stroke
Increased risk of Heart Disease
Type 2 Respiratory Failure

Question 5

Obstructive Sleep Apnoea Syndrome: Symptoms

Answer 5

Loud Snoring 
Unrefreshing Sleep 
Morning Headache
Poor Daytime Concentration 
Daytime Sommolence
Decreased Libido

Question 6

Obstructive Sleep Apnoea Syndrome: Typical Patient Descriptive

Answer 6

Obese
Middle aged
Male
Presents because of snoring or daytime somnolence.
His partner describes him as having apnoeic episodes during sleep.

Question 7

Obstructive Sleep Apnoea Syndrome: Investigations

Answer 7

-> Overnight sleep study - Polysomnography - diagnositic - monitors Pulse Oximetry, Oxygen Saturation, Airflow at the nose and mouth, ECG, EMG Chest, & Abdominal wall movement during sleep.
15 episodes or more during one hour of sleep = Severe Apnoea
-> Epworth Questionnaire: Questionnaire completed by the patient/and or their partner
-> Multiple Sleep Latency Test: measures the time to fall asleep in a dark room - using EEG criteria

Question 8

Obstructive Sleep Apnoea Syndrome: Treatment

Answer 8

-> Treat exacerbating factors:
Weight reduction = #1
Stop smoking
Reduce alcohol
-> CPAP - via nasal mask, first line medication for moderate/severe cases, after weight loss
-> Mandibular Repositioning Splint - may be used if CPAP is not tolerated or for patients with mild OSAS where there is no daytime sleepiness.
-> Treating Children: Adenotonsillectomy, CPAP, Weight Loss, Avoid tobacco smoke.

Question 9

Obstructive Sleep Apnoea Syndrome: Advice on Driving

Answer 9

DVLA should be informed if OSAS is causing excessive daytime sleepiness.