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Worldwide, obstructive sleep apnoea (OSA) is the most common medical disorder affecting sleep, afflicting about 3-4 percentage of the middle aged population of the UK, of whom about 70% are male. This chapter deals with the pathophysiology of the condition and its presenting features, investigations and treatment. Tonsillar hypertrophy should be recorded because this may be the underlying problem, and usually is so in children presenting with OSA. The gold standard of treatment for OSA is to submit the patient to nasal continuous positive airway pressure (nCPAP) whilst asleep. Although avoidance of sedative and opioid drugs during the peri-operative period is the recommended practice, sedatives and opioids have been used freely in conjunction with CPAP therapy without complication in the post-operative period. Post operative management involves nocturnal oxygen supply for at least one more night after opioid therapy has stopped.
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