OSA

Question 1

Define OSA?

Answer 1

Intermittent airway obstruction during sleep leading to cessation of breathing for atleast 10 seconds at a time often with heavy snoring

Question 2

What causes OSA?

Answer 2

Tends to be a combination of a narrow pharynx, obesity and abnormal relaxation of pharyngeal muscles (can be down to alcohol)
Some endocrine disorders do predispose e,g, hypothyroidism & acromegaly

Question 3

What is the danger of OSA?

Answer 3

Increases risk of stroke, hypertension, car accidents and impairs quality of life

Question 4

What are the signs or symptoms of OSA?

Answer 4

Endocrine problems may be visible
Daytime sleepiness
Lack of concentration
Snoring

Question 5

How do we investigate OSA?

Answer 5

• History
• Epworth sleep questionaire (both patient & spouse)
• Sleep Study

Question 6

How do we grade the severity of OSA?

Answer 6

By Apnoea-Hypopnea index (AHI), a measure of the number of pauses in breathing (for atleast 10 seconds) per hour, accompanied by desaturation

Normal = <5
Mild = 5-15
Moderate = 15-30
Severe = >30

Question 7

What are the types of sleep study available?

Answer 7

Overnight - Measuring Pulse & O2 sat
Limited - Add in nasal cannula to measure nasal air flow
Polysomnography - Done in hospital with ECG and recording. Usually unused

Question 8

How is OSA treated?

Answer 8

Treat exacerbatin factors:
e.g. weight loss and stop drinking

Check for endocrine disorders and treat (e.g. if any other signs of hypothyroidism send for thyrotropin test)

CPAP

Mandibular repositioning shunt (retainer that shifts jaw forward 1cm)

Advise avoiding driving