Obstructive Sleep Apnoea (OSA)

• Intermittent collapses or closures of the pharyngeal airway causing apnoeic episodes during sleep

Signs and Symptoms

• Symptoms: loud snoring, daytime somnolence, poor sleep, headache (usually in the morning), nocturia, decreased libido
• Signs: hypertension, obesity (associated), reduced cognitive performance
• Complications: pulmonary hypertension, type II respiratory failure

Investigation

• First-line: pulse oximetry and video recording during sleep
• Further investigation (if required): polysomnography
• Average of 15 or more episodes of apnoea or hypopnea during 1 h of sleep = significant OSA

Management

• Lifestyle measures: weight loss, avoidance of tobacco and alcohol
• Mandibular advancement device
• CPAP if moderate or severe OSA
• Resistant cases: surgery to relieve pharyngeal or nasal obstruction

Reference: Oxford Handbook of Clinical Medicine (10th Edition)