Summary

• Symptoms include loud snoring, gasping during sleep, apnoeas, unrefreshing sleep, and excessive daytime sleepiness.
• Obesity, retro- or micrognathia, oropharyngeal narrowing, and macroglossia are common physical features.
• Diagnosis is established using clinical evaluation plus polysomnography or portable sleep tests.
• Positive airway pressure or oral appliances are non-invasive treatment options.
• In patients unable to adhere to medical therapy or with discrete anatomical sites of obstruction, soft tissue and/or skeletal surgery may be selected for treatment of obstructive sleep apnoea.
• Complications of untreated obstructive sleep apnoea include increased risk of premature death, MI, dysrhythmias, stroke, HTN, motor vehicle accidents, metabolic syndrome, and neurocognitive dysfunction.
• Complications of continuous positive airway pressure (CPAP) treatment include sleep disturbance, rhinitis, dermatitis, conjunctivitis, aerophagia, and dyspnoea. Complications of oral appliance therapy include occlusal changes and facial pain. Complications of surgery include bleeding, haematoma, velopharyngeal insufficiency, pharyngeal stenosis, dysphagia, airway obstruction, and death.