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Sleep apnoea syndrome--a report of 14 cases
T H Cheong1, Y T Wang, S C Poh
1Department of Medicine III, Tan Tock Seng Hospital, Singapore.
Insights
Sleep apnoea syndrome increases patient morbidity and mortality. Tonsillectomy effectively treated obstructive sleep apnoea in patients with upper airway obstruction, while nasal continuous positive airway pressure helped others.
Area of Science:
- Sleep Medicine
- Otolaryngology
- Respiratory Medicine
Background:
- Sleep apnoea syndrome is linked to significant morbidity and mortality.
- Understanding patient characteristics and underlying pathologies is crucial for effective management.
- Obesity and hypertension are common comorbidities in sleep apnoea patients.
Purpose of the Study:
- To review the characteristics of patients diagnosed with sleep apnoea syndrome.
- To evaluate the effectiveness of tonsillectomy and nasal continuous positive airway pressure (CPAP) in treating specific types of sleep apnoea.
- To identify the role of upper airway obstruction in obstructive sleep apnoea.
Main Methods:
- Retrospective review of 14 patients diagnosed with sleep apnoea syndrome since 1986.
- Analysis of patient demographics, comorbidities (obesity, hypertension), and sleep study results (obstructive, central, mixed apnoea).
- Assessment of tonsillectomy and nasal CPAP efficacy based on symptomatic improvement and apnoea alleviation.
Main Results:
- 11 out of 14 patients had obstructive sleep apnoea (OSA), with 71% having nasal or throat pathology.
- Tonsillectomy provided significant symptomatic improvement in 4 out of 5 patients with enlarged tonsils causing upper airway obstruction.
- Nasal CPAP effectively managed apnoeas and symptoms in 4 patients without apparent upper airway obstruction.
Conclusions:
- Enlarged tonsils are a frequent cause of OSA in this patient cohort.
- Tonsillectomy is a simple and effective treatment for OSA secondary to tonsillar hypertrophy.
- Nasal CPAP is an effective alternative treatment for OSA, particularly when upper airway obstruction is not evident.
Abstract:
Patients with sleep apnoea syndrome suffer considerable morbidity and an increased mortality. We reviewed the characteristics of 14 patients with sleep apnoea syndrome (11 males and 3 females) who were studied since 1986. All were less than or equal to 60 years of age with the majority in their 4th and 5th decade. Obesity was present in 8 patients (57%) and hypertension in 6 (43%). Overnight sleep studies showed that 11 patients had obstructive sleep apnoea, 2 had central and one had predominantly mixed sleep apnoea. Ten patients (71%) had some form of nose and/or throat pathology. Tonsillectomy seemed an effective therapeutic procedure in those with upper airway obstruction due to enlarged tonsils. Four out of 5 patients had significant symptomatic improvement post-tonsillectomy. Nasal continuous positive airway pressure was also effective in alleviating apnoeas and relieving symptoms in 4 other patients who had no obvious upper airway obstruction. A high proportion of our patients had obstructive sleep apnoea due to enlarged tonsils. Tonsillectomy offered a simple and effective therapy for such patients. Nasal continuous positive airway pressure was also effective in the treatment of obstructive sleep apnoea.