Obstructive sleep apnoea

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Obstructive sleep apnoea Powered By Docstoc
					Obstructive sleep apnoea
Predisposing factors

      obesity
      macroglossia: acromegaly, hypothyroidism, amyloidosis
      large tonsils
      Marfan's syndrome

Consequence

      daytime somnolence
      hypertension
      Intellectual deterioration
      Morning headache
      Snoring
      Nocturnal enuresis.


SIGN guidelines for the diagnosis and management of patients with OSAHS were published in 2003

Assessment of sleepiness

      Epworth Sleepiness Scale - questionnaire completed by patient +/- partner
      Multiple Sleep Latency Test (MSLT) - measures the time to fall asleep in a dark room (using EEG
       criteria)

Diagnostic tests

      sleep studies - ranging from monitoring of pulse oximetry at night to full polysomnography where a
       wide variety of physiological factors are measured including EEG, respiratory airflow, thoraco-
       abdominal movement, snoring and pulse oximetry


Management

      weight loss
      CPAP is first line for moderate or severe OSAHS
      intra-oral devices (e.g. mandibular advancement) may be used if CPAP is not tolerated or for patients
       with mild OSAHS where there is no daytime sleepiness
      limited evidence to support use of pharmacological agents




Obesity hypoventilation eventually leads to chronic type II respiratory
failure and cor pulmonale. Patients often have coexisting obstructive sleep apnoea syndrome.

				
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Description: Obstructive sleep apnoea