Sleep Apnoea

Question 1

What are some complications of untreated sleep apnoea? Noting that main tx is weight loss

Answer 1

CVD: htn, stroke and
polycythemia

AF, diabetes, depression + anxiety, impotence are associated

(RACGP Sleep Check 2015)

Question 2

Does CPAP improve CVD risk?

Answer 2

Most recent trials did not show an effect on CVD risk, however severely sleepy (Epworth >16) were not included in the trial.

RACGP article

Question 3

What are features that increase the suspicion of osa?

Answer 3

witnessed apnoea
gasping/choking 
fragmented sleep
daytime sleepiness
morning headaches 
dec memory or concentration 
irritability and low mood 

RACGP Sleep Check 2015

Question 4

Epworth S Scale, score indicating significant sleepiness

Answer 4

equal or > 10

RACGP Sleep Check 2015

Question 5

Simple Snoring different to OSA?

Answer 5

Common, affects 40% adult population. Caused by vibration of tissues in the nasal passages or upper a/way

RACGP Sleep Check 2015

Question 6

Important examination

Answer 6

Vitals
BMI
Waist to hip ratio
Neck Circumference >42cm in men and >41cm in women
Mallampati Score
Nasal patency
Cranofascial anatomy and body composition

Cardiorespiratory: exclude cardiac failure and AF

Exclude hypothyroidism and acromegally

RACGP Sleep Check 2015

Question 7

Factors that increase the risk of mva?

Answer 7

ESS > 16
previous history of falling asleep at the wheel
MVA due to falling asleep

15fold increase

urgent referral to sleep physician

RACGP Sleep Check 2015

Question 8

Risk factors for OSA?

Answer 8

male
50’s
overweight
increase tonsil size

RACGP Sleep Check 2015

Question 9

What is the apnoea hypopnea Index?

Answer 9

Number of apnoeas (cessation of breathing) and hypopnoeas (reduction in breathing) per hur

AHI 5-15 = mild OSA
AHI 16-30= moderate OSA
AHI>30 = severe OSA

RACGP Sleep Check 2015

Question 10

What is the overweight/obesity BMI for south Asian, Chinese and japanese groups?

Answer 10

BMI 23-24 vs 25-30 in other groups

RACGP Sleep Check 2015