Obstructive Sleep Apnoea

Respiratory

Recurrent upper airway collapse during sleep causing intermittent hypoxia, arousals and daytime sleepiness.

Clinical features

  • Snoring, witnessed apnoeas
  • Unrefreshing sleep, morning headache
  • Excessive daytime sleepiness (Epworth ≥11)
  • Nocturia

Investigations

  • STOP-BANG and Epworth scores
  • Home respiratory polygraphy or polysomnography (AHI)
  • Consider ABG if obesity hypoventilation suspected

Management

  • Weight loss, alcohol and sedative avoidance, positional therapy
  • CPAP for moderate-severe or symptomatic mild OSA
  • Mandibular advancement device for mild disease
  • ENT review for surgically correctable anatomy

Clinical pearls

  • Driving advice is mandatory — inform licensing authority if sleepy
  • Untreated OSA causes resistant hypertension and AF recurrence

Related in WardRound

Educational — verify locally.

WardRound

WardRound

Clinical Decisions in Seconds