Sleep Apnoea (1B)

Question 1

What is obstructive sleep apnoea syndrome?

Answer 1

Obstructive sleep apnoea syndrome (OSAS) is a sleep-related breathing disorder characterized by recurrent episodes of complete or partial obstruction of the upper airway during sleep, causing apnoea

Question 2

What symptoms may a person with sleep apnoea present with?

Answer 2

Excessive daytime sleepiness

Snoring

Witnessed apnoeas while sleeping

Disrupted sleep

Impaired concentration

Impact on driving and working

Question 3

What are risk factors for sleep apnoea?

Answer 3

• obesity
• hypothyroidism
• family history
• macroglossia (large tongue)
• large tonsils

Question 4

What is a screening questionaire that can be used to assess the severity of sleep apnoea

Answer 4

Epworth sleepiness scale

Question 5

How is the diagnosis of sleep apnoea confirmed?

Answer 5

Polysomnography (PSG)

What is this?
The patient is recorded using wires measuring various parameters including rapid eye movements, oxygen saturations and the electrical activity of the brain.

Question 6

What is the first-line treatment for sleep apnoea and what other lifestyle advise can be given to the patient?

Answer 6

CPAP therapy (first-line)

Other:
- weight loss
- the DVLA should be informed if causing excessive daytime sleepiness

Question 7

A 43-year-old male presents with episodes of waking up in distress. He describes late at night feeling breathless with his heart is racing. These episodes are becoming more frequent and it is worrying him immensely. His wife also adds that he snores loudly which sometimes subsides if he changes position. As well as this, he finds himself taking short naps during the day which is affecting his job as an IT technician. Past medical history includes type 2 diabetes and obesity.

Which of the following is the best investigation in the diagnosis of the patient’s condition?

A) Drug-induced sleep endoscopy (DISE)

B) Multiple Sleep Latency Test (MSLT)

C) Cinematic MRI

D) Arterial blood gas (ABG)

E) Polysomnography (PSG)

Answer 7

E) Polysomnography (PSG)

Question 8

A 55-year-old man comes to see you with his wife. His wife has noticed that he often wakes up in the middle of the night and struggles to breathe. He describes feeling very tired during the day and often falls asleep while reading the newspaper. You suspect a diagnosis of moderate sleep apnoea and refer him for further assessment. He would like to know more about the treatment of sleep apnoea

Which one of the following is the first line treatment for moderate sleep apnoea?

A) Bilevel Positive Airway Pressure (BiPAP)

B) Home oxygen therapy

C) Salbutamol inhaler

D) Steroid inhaler

E) Continuous positive airway pressure (CPAP)

Answer 8

E) Continuous positive airway pressure (CPAP)