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Obstructive sleep apnoea (OSA) - Coggle Diagram
Obstructive sleep apnoea (OSA)
Clinical features
loud snoring
witnessed pauses in breathing (apnoeas)
restlessness
disturbed sleep
excessive daytime sleepiness
learning/behaviour problems
acute life-threatening CR events
pul HTN in severe cases
usually due to upper airway obstruction secondary to adenotonsillar hypertrophy in children
Risk factors
obese (but may have growth failure)
hypotonia
muscle weakness
Downs
achondroplasia
NM disease
CP
craniofacial abnormalities
Dx
overnight pulse oximetry
if normal does not excl OSA
polysomnography required in more complex cases
monitors HR, resp effort, airflow, art pCO2, video recording
can distinguish between central + obstructive events
e.g. OSA vs congenital central hypoventilation syndrome (genetic mutation results in disordered central control of breathing, can cause death in infancy, tx = long term ventilation)
sometimes EEG, EOG + submental EMG needed to assess neuro arousals + sleep staging
Tx
adenotonsillectomy usually curative
risk of periop comps if severe overnight hypoxaemia
CPAP/BiPAP