Abstract

About 4% of men and 2% of women of working age suffer from sleep apnoea syndrome. It may occur at any age but most patients are middle-aged men or postmenopausal women. Sleep apnoea is the most common organic cause of abnormal daytime sleepiness. In most cases apnoea/hypopnoea during sleep is caused by obstruction of the upper respiratory tract during sleep (obstructive sleep apnoea), or by disturbance of central respiratory control (central sleep apnoea). The latter form is rare and is usually associated with disorders of the central nervous system or heart failure. Typical symptoms of obstructive sleep apnoea are loud intermittent snoring and episodes of apnoea during sleep. These symptoms are associated with disturbed sleep at night, nocturia and nocturnal sweating, nocturnal arrhythmias, and nocturnal attacks of chest pain. In the  daytime these persons are tired, they have often morning headaches and excessive sleepiness.
The most important risk factors of obstructive sleep apnoea are overweight (50-70% of patients), narrow pharynx, slack soft palate, swollen uvula, large tonsils, narrow nose, large tongue, small or backward-sloping lower jaw, short and thick neck.
An effective tool in treatment of obstructive sleep apnoea is application of continuous positive airway pressure (CPAP). Patient symptoms, other diseases, the risk associated with sleep apnoea and polysomnographic finding must be considered before starting CPAP.
Surgical treatment is indicated in 5-10% of patients with sleep apnoea. Dilative pharyngeal surgery (uvulopalatopharyngoplasty, tonsillectomy), dilative nasal surgery (septoplasty, removal of polyps) or maxillofacial operation may be effective in selected cases.