Obstructive sleep apnoea

Clinical features

• Obese middle aged men present due to snoring of day time somnolence
• Snores loudly during sleep
• Morning headache
• Daytime somnolence
• Decreased libido
• Poor sleep quality
• Reduced cognitive performance

Complications

• Pulmonary hypertension
• Type II respiratory failure
• Hypertension (independent risk factors)

Investigations

• Polysomnography is diagnostic (monitors oxygen saturation, airflow at the nose and mouth, ECG, EMG chest and abdominal wall during sleep)
• The incidence of 15 or more episodes during one hour of sleep indicates significant apnoea

Management

• Weight reduction
• Avoidance of alcohol and tobacco
• CPAP during sleep
• Surgical procedures to relievepharyngeal obstruction may occasionally be needed e.g. tonsillectomy, uvulopalatopharynoplasty or tracheostomy