AAO-HNSF Primary Care Otolaryngology Handbook

CHAPTER 18

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a common disease for an otolaryngolo- gist to see and treat, with many patients presenting with complaints of snoring. It is important for the practitioner to determine whether the patient has primary snoring or OSA. OSA manifests itself as partial or complete airway obstruction while sleeping and is more commonly seen in male and obese patients. If left untreated, OSA can result in medical consequences. This is especially true with moderate to severe OSA, which is associated with increased risk of stroke, myocardial infarction, atrial fibrillation, insulin resistance, and cognitive decline. A thorough history is necessary to determine the patient’s sleep patterns and complaints. A good sleep history should include: • Bedtime • Time to fall sleep once in bed • Number of awakenings during the night • Wake time • Time out of bed

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• Severity of snoring • Witnessed apneas • Daytime sleepiness • Morning headaches • Motor vehicle accidents due to sleepiness • Naps

In addition to these questions a medical history should be obtained to determine whether the patient has hypertension, coronary artery disease, cardiac arrhythmias, disorders of glucose metabolism, thyroid disease, or cognitive changes.

Primary Care Otolaryngology