Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • noisy breathing during sleep
  • apnoeas
  • choking or gasping

Other diagnostic factors

  • waking up tired
  • daytime somnolence
  • hyperactivity
  • behavioural problems
  • night terrors
  • enuresis

Risk factors

  • increasing age
  • male gender
  • obesity (BMI >30)
  • cranio-facial abnormalities
  • endocrine disorders
  • neck circumference above 40 cm
  • sedating medications
  • adenotonsillar hypertrophy
  • long soft palate and uvula
  • alcohol consumption
  • Down's syndrome
  • gastro-oesophageal reflux
  • active or passive smoking
  • abnormal epiglottis
  • hypo-pharyngeal cysts or tumours
  • rhinitis/nasal obstruction
  • asthma

Diagnostic investigations

1st investigations to order

  • nasal decongestant test
  • Epworth sleepiness score (ESS)
Full details

Investigations to consider

  • snoring scale score
  • TFTs
  • growth hormone level
  • allergy tests
  • sleep study
  • acoustic analysis
  • pharyngeal manometry
  • sleep nasendoscopy
Full details

Emerging tests

  • head and neck 3-dimensional CT
  • head and neck MRI
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Specialty Registrar in Otorhinolaryngology-Head & Neck Surgery

Sheffield Teaching Hospitals NHS Trust

Sheffield

UK

Disclosures

NA declares that she has no competing interest.

Consultant in Otorhinolaryngology-Head & Neck Surgery

Sheffield Teaching Hospitals NHS Trust

Sheffield

UK

Disclosures

SM has been reimbursed by Arthocare, one of the manufacturers of radiofrequency hardware, for attending a conference and course.

Peer reviewers VIEW ALL

Assistant Professor of Surgery

Section of Otolaryngology-Head and Neck Surgery

University of Chicago

Chicago

IL

Disclosures

JP declares that he has no competing interests.

Director

Department of Respiratory and Sleep Medicine

John Hunter Hospital

Professor and Head

School of Medicine and Public Health

Faculty of Health

The University of Newcastle

NSW

Australia

Disclosures

MJH declares that he has no competing interests.

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