Obstructive sleep apnoea/hypopnoea syndrome

Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is a condition in which a person experiences repeated episodes of apnoea/hypopnoea because of closing of the pharyngeal airway during sleep (NICE definition) 

Symptoms 

• Excessive daytime sleepiness 
• Snoring 
• Morning headaches 
• Nocturia 
• Sexual dysfunction 
• Impaired cognition 

Risk factors for OSA

• Increasing age
• Obesity 
• Male gender 
• Enlarged tongue or tonsils 

Conditions associated with OSAHS 

• Marfans 
• Downs 
• Acromegaly 
• Hypothyroidism 

Diagnosis 

• History 
• Sleep study 
• Severity graded on the apnoea/hypnoea index (AHI) 
• Mild: AHI 5-14 
• Moderate: AHI 15-30 
• Severe: AHI >30 

Management 

• Lifestyle changes 
• Weight loss 
• Stop smoking 
• Decrease alcohol 
• Dental devices to keep upper airway open (mild to moderate OSA only)
• CPAP 
• Surgery should only be as part of a clinical trial 

OSAHS increases: 

• Depression 
• Hypertension 
• Increased motor accidents 

References

Eishaug, A. et al. Upper airway surgery should not be first line treatment for obstructive sleep apnoea in adults. BMJ. 2008; 336(7634): 44-45. 

NICE. Continuous positive airway pressure for the treatment of obstructive sleep apnoea/hypopnoea syndrome. 2008. Available at http://publications.nice.org.uk/continuous-positive-airway-pressure-for-the-treatment-of-obstructive-sleep-apnoeahypopnoea-ta139 

Riha, R., Gislasson, T. and Diefenbach, K. The phenotype and genotype of adult obstructive sleep apnoea/hypopnoea syndrome. Eur Respir J. 2009; 33(3):646-655.