Obstructive sleep apnoea

What it is

Obstructive sleep apnea (OSA) is a sleep-related breathing disorder in which airflow significantly decreases or ceases because of upper airway obstruction, typically in the oropharynx.

Causes and risk

The causes and risk factors are:

• Obesity, especially around the neck, giving the short, wide bull neck
• Adenotonsillar hyperplasia
• Nasal septum deviation and nasal polyps
• Alcohol
• Intake of sedatives and/or beta blockers before sleep
• Acromegaly

An increased neck size is the most important risk factor for OSA.

How it presents

During sleep the patient has restless sleep with waking, gasping, or choking, and loud, irregular snoring with apneic episodes. During the day there is excessive daytime sleepiness, morning headaches, and impaired cognitive function such as impaired concentration and memory loss. Depression and hypertension also belong to the picture. Obstructive sleep apnea is one of the most common causes of secondary hypertension.