Obstructive Sleep Apnoea

Question 1

What are presdisposing factors to obstructive sleep apnoea?

Answer 1

• Obesity
• Macroglossia (acromegaly, hypothyroid, amyloidosis)
• Large tonsils
• Marfan’s syndrome

Question 2

The partner often complains of excessive snoring and may report periods of apnoea.

What are consequential features experienced from OSA?

Answer 2

• Daytime somnolence
• Compensated respiratory alkalosis
• Hypertension

Question 3

How can sleepiness be assessed?

Answer 3

• Epworth Sleepiness Scale → completed by pt +/- partner
• Multiple Sleep Latency TEst (MSLT) → measures time to fall asleep in dark room (using EEG criteria)

Question 4

What are diagnostic tests for OSA?

Answer 4

• Sleep studies (polysomnography)
• Ranges from monitoring of pulse oximetry at night to full polysomnography where a wide variety of physiological factors are measured including EEG, respiratory airflow, thoraco-abdominal movement, snoring + pulse oximetry

Question 5

What are the management options for OSA?

Answer 5

• Weight loss
• Mod-severe OSA → CPAP
• CPAP intolerable / mild OSA → intra-oral devices
• Excessive daytime sleepiness → DVLA informed