OSA - snoring hx
o Timing questions- since when, getting worse, previous episodes
o Do you stop breathing? For how long? Do you wake up choking?
o Headache in the morning? Refreshed? Reduced concentration?
o Fall asleep at work/in front of the TV? Drive?
o IMPACT on life
o Collar size, weight, alcohol consumption; thyroid hx (causes OSA)
OSA - Ix
o Test TFTs, HbA1c, lipid profile, ABG, Spirometry, BMI, BP
o Questionnaires for OSA- Epworth sleepiness scale and sleep habit questionnaire (Epworth scale total score is 0-24, refer to Resp if: dangerous, score >9, COPD)
o Overnight oximetry is looking at the frequency of 4% dips in oxygen saturations
o Polysomnography to look at the AHI (apnoea/hyponoea index) moderate = >15 per hour
OSA - Mx
o Management: stop driving, stop smoking, weight loss, avoid alcohol and sedatives and sleeping tablets, don’t sleep on your back. Intraoral device if mild, CPAP if moderate
OSA - risks
o CVS - HTN, AF, stroke
o Resp - cor pulmonale and T2RF,
o Met - Diabetes
OSA - patient info
o Explain that breathing stops for short spells whilst asleep because of obstruction to flow of air down airway. Throat muscles go relaxed and floppy
o Need to measure your height and weight, collar size, BP, oxygen levels
o Need to do blood tests for thyroid function, diabetes, cholesterol
o Will give you 2 questionnaires to complete and partner to complete too
o Will arrange overnight pulse oximetry and tests of lung function
o Will refer to Respiratory doctor
o In the meantime: stop driving, stop smoking, weight loss, avoid alcohol and sedatives and sleeping tablets, don’t sleep on your back
