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Common Obstructive Sleep Apnoea (OSA) exam questions for medical finals, OSCEs and MRCP PACES

 

Question 1.

What are risk factors for obstructive sleep apnoea (OSA)?

  • Structural
    • Nasal Obstruction
      • Polyps
      • Septal deviation
      • Tumours
      • Trauma
      • Stenosis
    • Pharyngeal Obstruction
      • Adenotonsillar hypertrophy
      • Mandibular hypoplasia
      • Micrognathia
      • High arched palate
      • Syndromes – Downs, Marfans, Prader-Willi, Acromegaly
  • Non-Structural
    • Obesity – especially central fat distribution and large neck circumference (>17 inches)
    • Alcohol and sedative use
    • Smoking
    • Age and male sex
    • Postmenopausal state
    • REM sleep
    • Supine sleep position

 

Question 2.

What are the complications of obstructive sleep apnoea (OSA)?

  • Hypertension
  • Ischaemic heart disease (IHD)
  • Diabetes
  • Depression
  • Sleepiness-related accidents (patients with OSA have 2-7 times increased risk of motor vehicle crashes compared to controls)

 

Question 3.

When should people with obstructive sleep apnoea (OSA) be treated?

  • Symptomatic patients with AHI ≥ 15 or a 4% oxygen desaturation rate at the level of > 10/hour

 

Question 4.

What are the possible treatments in obstructive sleep apnoea (OSA)?

  • Behavioural interventions
    • Weight loss
    • Avoidance of alcohol, sleeping tablets and sedatives
    • Smoking cessation
  • Non-Surgical
    • CPAP
    • BiPap in patients with ventilatory failure
    • Intra-oral devices
  • Surgical
    • Palatal surgery