Obstructive sleep apnoea

This syndrome is characterized by recurrent upper airway obstruction during sleep when the loss of normal pharyngeal tone allows the pharynx to collapse passively during inspiration.

Aetiology

Male gender

Obesity

Tonsillar hypertrophy

Nasal obstruction

Hypothyroidism

Acromegaly

Ingestion of alcohol or sedatives before sleep

Clinical features

Snoring

Apnoea episodes

The patient complains of daytime sleepiness, he feels he has been asleep all night but wakes refreshed.

Difficulty in concentration

Impaired cognitive function

Impaired memory and work performance

Morning headaches

loss of libido

Irritability

Examination

Nasal obstruction

Narrow oropharynx due to excessive soft tissue folds, large tonsils, or prominent tongue.

Features of pulmonary hypertension or cor pulmonale may be present. – In adults

Investigations

Polysomnography: this is the overnight study of breathing, oxygenation (oxygen saturation)

Management

Treatment of the cause

Weight loss

Strict avoidance of alcohol and hypnotic medications.

Notify Driving authority – In the case of adults

Sleep physician referral/ Paediatrician referral

Nasal continuous positive airway pressure (nasal CPAP) is curative in many patients.

Treatment of curable conditions such as a deviated nasal septum, Tonsillar hypertrophy