Sleep Apnoea

Question 1

What is obstructive sleep apnoea/hypopnoea syndrome (OSAHS)?

Answer 1

Common sleep disorder characterised by recurrent episodes of partial or complete upper airway obstruction during sleep, leading to intermittent hypoxia and arousals from sleep.

Question 2

What are the risk factors for OSA/HS?

Answer 2

• Obesity
• Age +++ and Male
• Menopause
• Family History
• Anatomical factors
• Alcohol + sedatives
• Smoking
• Medical Conditions: PCOS, acromegaly, hypOthyroidism

Question 3

What is the pathophysiology of OSAHS?

Answer 3

**Wakefullness - sleep cycles: **
* Reduced muscle tone during sleep
* Negative pressure generated by inspiration leads to airway collapse
* Reduction (hypopnoea) or cessation (apnoea) of airflow despite ongoing respiratory efforts.

Question 4

What are common symptoms of OSAHS?

Answer 4

• Excessive snoring + periods of apnoea (reported by partner)
• Disturbed sleep
• Daytime somnolence
• Hypertension
• Compensated respiratory acidosis

Question 5

What is the Epworth sleepiness scale?

Answer 5

A questionnaire commonly completed with a partner to formally assess OSAHS.

Question 6

What does the Multiple Sleep Latency Test (MSLT) measure?

Answer 6

Time to fall asleep in a dark room using ECG criteria - diagnostic test for OSAHS.

Question 7

What is polysomnography?

Answer 7

Sleep study monitoring during a night’s sleep (pulse ox., ECG, airflow…).

Question 8

What are the management options for OSAHS?

Answer 8

• Weight loss
• CPAP - continuous positive airway pressure
• Intra-oral devices (e.g. mandibular advancement)

Question 9

True or False: The DVLA should be informed if OSAHS causes excessive daytime sleepiness.

Answer 9

True

Question 10

What are some long-term complications of OSAHS?

Answer 10

• Hypertension
• Cardiovascular disease
• Metabolic disorders