Obstructive sleep apnea

Question 1

What is it?

Answer 1

Interrupted sleep patterns due to obstruction of the upper airways of the lungs

Question 2

Aetiology

Answer 2

smooth muscle relaxation
obesity
snoring narrow pharynx
02 desaturation

Question 3

symptoms

Answer 3

high frequency microarousals
poor concentration
daytime somnolence

Question 4

social consequences

Answer 4

marital problems
Road traffic accidents- DVLA should be alerted/ should not be driving
Can lead to an increase in hypertension associated with stroke/MI

Question 5

Investigation

Answer 5

• epworth questionnaire
• limited sleep test
• Polysomnography
• Pulse oximetry- should be over 92%

Question 6

What does polysomnography measure?

Answer 6

• ECG
• EOG-EMG-peripheral pulses
• 02 sats
• oralnasal movement
• thoraco-abdominal movements

Question 7

Treatment

Answer 7

1-diagnose underlying cause 
-weight loss
-alcohol consumption reduction 
-endocrine disorders treated 
2- continuos positive airway pressure 
3-mandibular repositioning splint 
4-adenotonsillectomy

Question 8

Severity based on polysomnography?

Answer 8

<5 normal
5-15: mild
15-30: moderate
>30 severe

Question 9

Differences between OSAS in children and adults?

Answer 9

Obesity: major symptom in adults 
Daytime sleepiness: major symptoms in adults 
Mouth breathing: only in children 
Ratio:
-adults: M:F= 2:1
-children: M:F= 1:1 
Enlarged tonsils in children is common 
Obstructive pattern:
-in children: hypoventilation 
-in adults: apnea

Question 10

What can it lead to?

Answer 10

• Cor pulmonale
• failure to thrive
• systemic hypertension
• neurocognitive diseases such as adhd