Sleep Apnoea
Respiratory (12%) Core Clinical Conditions
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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management
Definition
Sleep apnoea is a medical condition where there is a pause or shallow breathing during sleep. This can occur several times during sleep and it can last a few seconds to a minute. The most common form of sleep apnoea is obstructive sleep apnoea (OSA).
Aetiology
Intermittent narrowing of the airway during sleep. Caused by the relaxation of the muscles in the throat when sleeping.
Pathophysiology
When laying flat > increased pressure to pharynx > obstruction of airways.
The narrowing of the airways > turbulent airflow > snoring.
Also due to intermittent narrowing > hypoxia > central nervous system compensates the hypoxia by increasing the respiratory effort > patient wakes up.
Risk factors
Obesity.
Structural abnormalities such as enlarged tonsils, deviated septum, nasal polyp etc.
Family history.
Alcohol consumption.
Sign and symptoms
Snoring and daytime sleepiness.
Low mood.
Low libido.
O/E: high BMI, may have hypertension, arrhythmia.
Diagnosis and investigations
The Epworth Sleepiness Scale is a questionnaire to check day time sleepiness.
Polysomnography (sleep study overnight).
Management
Lifestyle modification: weight loss, exercise, avoid alcohol and sleep in non supine positions.
If severe, a Continuous positive airway pressure (CPAP) macchine will provide positive pressure which will prevent upper pharynx occlusion.
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