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.

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