Obstructive sleep aponea

Question 1

Define:

Answer 1

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

Question 2

Aetiology:

Answer 2

Narrowing of the upper airways because of the collapse of soft tissue of the pharynx

Decreased tone of the pharyngeal dilators during sleep which means that the airway is not held open as easily.

Affects OBESE, middle aged men presenting with snoring but partner reporting aponea.

Question 3

Risk factors:

Answer 3

Weight gain (obesity - soft tissue around the neck)

Surgical swelling

Smoking

Alcohol

Sedative use

Enlarged tonsils + adenoids

Macroglossia

Marfan’s

Cranofacial abnormalities

Question 4

Epidemiology:

Answer 4

Common

5-20% of men >35 years

2-5 % of women >35 years

Prevalence increases with age

Question 5

Symptoms:

Answer 5

Excessive daytime sleepiness

Morning headaches

Unrefreshing or restless sleep

Dry mouth

Difficulty concentrating

Irritability and mood swings - cognitive decline and decreased libido

Loud snoring

Question 6

Signs:

Answer 6

Large tongue

Enlarged tonsils

Long or thick uvula

Neck circumference (>42 cm in males and >40cm in females)

Obesity

Hypertension

Question 7

Investigations:

Answer 7

Pulse ox

Video recording

Polysommography:
-Overnight monitoring of: pulse ox, snoring, movement, heart rate, airflow, resp effort

Bloods - TFT’s, ABG