snoring and OBA Flashcards
Snoring
Stertorous sound while asleep caused by turbulent airflow in the upper aerodigestive tract
Usually at level of soft palate, tonsils and tongue base
OSA
Greater than 10 seconds of temporary cessation of breathing (apnoea) while sleeping
Caused by obstruction of airflow in the upper aerodigestive tract
can cause heart problems
Central Sleep Apnoea
rare
lack of central drive rather than airway obstruction therefore snoring as a symptom is less common
mild, moderate and severe OSA
Mild = 5 - 15 episodes per hour
Moderate = 15 - 30 episodes per hour
Severe = >30 episodes per hour
Risk factors for Snoring & OSA
High BMI
Older Age
Physical/structural
Large tonsils +/- adenoids
Small mandible / retrognathia – e.g. Pierre Robin sequence, Goldenhaar Syndrome, Treacher Collins Syndrome
Macroglossia – e.g. Down’s Syndrome
Drugs
Alcohol
Benzodiazepines
diagnosis of OSA
Neck Circumference
Epworth Sleepiness Score – daytime somnolence
oral cavity, nose and flexible nasal endoscopy to assess the level generating the snoring
thyroid function
Polysomnography
Limited sleep study includes recording pulse oximetry
Nasal & oral airflow
Chest circumference
Abdominal circumference
management of snoring
devices- from the tongue base level the use of a mandibular advancement splint
surgical -tonsil and soft palate level, uvulopalatopharyngoplasty (UPPP), rare/ device to palate to stiffen radiofrequency probe to cause scarring
OSA management
Devices
CPAP
Mandibular Advancement Splint
surgical- same as snoring
snoring and OSA management in kids
snoring- commonly due to enlargement of tonsils and adenoids , if doesn’t go away then Adenotonsillectomy
OSA- Adenotonsillectomy