Clinical Case Database / Category: Patient Management

Early diagnosis of obstructive sleep apnoea

Publication details

Dr Steven Law MBBS, MRCP, Dr Anita Jayadev MBBS, MRCP, Dr Himender K Makker DM, FRCP
Foundation Years Journal, volume 9, issue 4, p.20 (123Doc Education, London, April 2015)

Abstract

Obstructive Sleep Apnoea Syndrome (OSAS) describes a disordered sleep
breathing pattern associated with recurrent apnoea and a range of symptoms
including daytime somnolence. It is becoming increasingly common as the
prevalence of obesity rises. Evidence demonstrates a significant impact
on quality of life and increased risk of several co morbidities which can
be improved with safe non-invasive treatment in the form of continuous
positive airway pressure (CPAP). As a foundation doctor you will inevitably
see patients with symptoms of OSAS and this article provides you with the
tools to highlight those at risk and make the diagnosis early.

Access the Clinical Cases Database

A subscription is required to read the full article. Please subscribe using one of the options below.

Authors

Dr Steven Law MBBS, MRCP

Core Trainee in Respiratory Medicine
Department of Respiratory Medicine
North Middlesex University Hospital NHS Trust
Sterling Way, London, N18 1QX
stevenlaw@nhs.net

Dr Anita Jayadev MBBS, MRCP

Specialist Registrar in Respiratory Medicine
North Middlesex University Hospital NHS Trust
Sterling Way, London, N18 1QX
anitas184@gmail.com

Dr Himender K Makker DM, FRCP (Corresponding author)

Consultant Physician in Respiratory Medicine
North Middlesex University Hospital NHS Trust
Sterling Way, London, N18 1QX
himendermakker@gmail.com

References

1. Johns MW. A New Method For Measuring Daytime Sleepiness: The Epworth Sleepiness Scale. Sleep 1991; 14:540-5
2. Obstructive Sleep Apnoea. Sign. 2003 3. IMPRESS – sign/BTS
4. Chapman S, Robinson G, Stradling J et al. Oxford Handbook of respiratory Medicine. Chapt 47. P568-590
5. Simcock DE and Makker HK. Sleep Apnoea - Good Medical Practice. Foundation Years Journal: vol. 3, iss. 6 - Respiratory 2009. 7:40
6. Seetho W and Wildin JP. Screening for obstructive sleep apnoea in obesity and diabetes – potential for future approaches. Eur J Clin Inv. 2013 June;43 (6):640-55
7. Rosenzweig L, Williams SC, Moreell MJ. The impact of sleep and hypoxia on the brain: potential mechanisms for the effects of obstructive sleep apnoea. Curr Opin Pulm Med. 2014 Nov;20(6):565-71
8. Lucciano F, Luiz A et al. Effects of Continuous Positive Airway Pressure on early Atherosclerosis in obstructive Sleep Apnoea. American Journal of Resp and critical care Medicine. 2007 Oct. Vol 176(7):706-712
9. Koehler U et al. Obstructive Sleep Apnoea in neurological diseases: Specially as a risk factor for stroke. Nervenarzt. 2014 Jan; 85(1):35-42
10. Väyrynen K, Kortelainen K, Numminen H, et al. Screening sleep disordered breathing in Stroke Unit. Sleep Disorders 2014.
11. Evans RS, et al. Early detection of hospitalized patients with previously diagnosed obstructive sleep apnoea using computer decision support alerts. Stud health Technoil Inform. 2013; 192:505-9
12. Deegan PC, McNicholas WT. Predictive value of clinical features for the obstructive sleep apnoea syndrome. European Respiratory Journal. 1996, 9, 117-124
13. Morris, L.G et al. Rapid risk stratification for obstructive sleep apnoea, based on snoring severity and body mass index. Journal of otolaryngology and Head and Neck Surgery. 2008.Nov: 139(5):615-8
14. Ramero, E. Krakow, B. et al. Nocturia and snoring: Predictive symptoms for Obstructive sleep apnoea. Sleep and Breathing. 10/2009: 14(4): 337- 43
15. Canessa N et al. Obstructive slepp apnoea: brain structural changes and neurocognitive function before and after treatment. American Journal Resp and Crit Care Medicine. 2011. May 15; 183(10):1419-26
16. Kohler, M. Stoewhas A.C., et al. Effects of Continuous Positive Airway Pressure withdrawal in patients with Obstructive Sleep Apnoea. A randomized Control Trial. American Journal of Respiratory and Critical Medicine. 2011 Vol 184(10):1192-1199
17. Jennum, P, Ibsen, R, Kjellberg J. Morbidity prior to a diagnosis of sleep disorderd breathing: a controlled national study. Journal of Clinical Sleep Medicine. 2013 Feb 1;9(2):103-8
18. El-Sayed, I.H. Comparison of four sleep questionnaires for screening obstructive slepp apnoea. Egyptian Journal of Chest Diseases and Tuberculosis. Oct 2012. VO, 61, Issue 4, P 433-441
19. Luo J et al. STOP-Bang Questionnaire is superior to Epworth Sleepiness Scales, Berlin Questionnaire, and STOP questionnaire in screening obstructive sleep apnoea hyponoea syndrome in patients. Chinese
Medical Journal. 2014;127(17):3065-70
20. Continuous positive airway pressure for the treatment of obstructive sleep apnoea/hypopnoea syndrome: NICE Guidelines. March 2008
21. Bradley TD, Floras JS. Obstructive sleep apnoea and its cardiovascular consequences. Lancet, January 2009, 3;373(9657):82-93
22. Simcock D, Makker HK. Management of Obstructive sleep apnoea. Foundation Year Journal 2009;3;40-45
23. Turkington PM, Sircar M, Allgar V, et al. Relationship between obstructive sleep apnoea, driving simulator performance, and risk of road traffic accidents. Thorax 2001. 56:800-805
24. Driving and Obstructive Sleep Apnoea (OSA)/Obstructive Sleep Apnoea Syndrome (OSAS). British Thoracic Society. June 2014

Figure references
1. Yee M. What is Obstructive Sleep Apnea (OSA)? Osborne Head&Neck Institute. http://www.ohniww.
org/sleep-apnea-treatment-los-angeles-ent/
2. L'Eplattenier B. Obstructive Sleep Apnea (OSA, still a stranger in Orthodontics). Orthodontic Reviews.
Nov 2012. http://orthodonticreviews.blogspot.co.uk/2012/11/obstructive-sleep-apnea-osa-still.html
3. Watson S. Weight loss, breathing devices still best for treating obstructive sleep apnea. Harvard
Health Publications. Oct 2013. http://www.health.harvard.edu/blog/weight-loss-breathing-devicesstill-
best-for-treating-obstructive-sleep-apnea-201310026713

Disclaimers

Conflict Of Interest

The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (http://www.icmje.org/urm_full.pdf).

Financial Statement

The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.

Patient Consent statement

All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts (http://www.icmje.org/urm_full.pdf). The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.

Animal & Human Rights

When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.

About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.