Pathology: Episodes ofapnoea during sleep caused by collapse/obstruction of the pharyngeal airways,terminated by partial waking resulting in fragmented sleep
Aetiology: Mostcommonly seen in overweight, middle-aged men and is made worse by alcohol.Upper airways abnormalities e.g. large tonsils, can sometimes be the cause
Symptoms: Daytimesleepiness, morning headaches, disturbed sleep, decreased libido, partners willreport snoring and apnoea
Signs: Overweight
Investigations: EpworthSleep Scale is a questionnaire designed to measure daytime sleepiness. Overnightpulse oximetry will show frequent desaturations which resolve on waking. Sleepstudies may be needed if overnight oximetry not diagnostic.
Treatment: Reduce weight and avoid alcohol, continuous positive airways pressure(CPAP)
Surgeryis sometimes used to correct upper airways abnormalities
Complications: Pulmonaryhypertension leading to cor pulmonale, hypertension, type 2 respiratory failure
Prognosis: Dependenton development of vascular complications, can resolve if sufficient weight loss
