Data gathering
- Red flags – fall asleep while driving
- Others – witnesses, snoring, concentrating, daytime sleepiness
- Examine – BMI, ENT
Clinical management
- Investigations
- Epworth sleepiness scale
- Bloods – FBC, TFTs
- Explanation
- breathing stops for short spells when asleep, occurs because throat muscles relax and become so floppy they block the airway – this wakes you up briefly several times at night
- Treatment
- Lifestyle – weight loss, decrease alcohol, stop smoking, sleep on side, ear plugs for partner
- Mandibular advancement device (dental appliance similar to gum shield)
- Safety net – if above not helping
- Follow-up / Safety net
- Refer sleep clinic – sleep study, CPAP, surgery
- DVLA (if daytime sleepiness)