Obstructive sleep apnoea (OSA) is characterised by repetitive pharyngeal collapse during sleep, which can be either partial or complete. The resulting disruption to gas exchange can cause oxygen desaturation, hypercapnia and fragmented sleep.
This case study looks at difficult-to-treat OSA in adults and the use of novel treatments such as GLP-1/GIP agonists to improve symptom burden.
Mark is a 47-year-old Pākehā man who works as an accountant.
He presents to your clinic as he is concerned about his sleep. For the last 10 years, he has had trouble with daytime sleepiness, waking up in the morning feeling tired. Over the last 2 years, his wife has noticed that his snoring has got louder and that he stops breathing throughout the night.
He has tried altering his sleep position, e.g. sleeping on his side and with more pillows, but this has not helped. After reviewing some online chat groups, he also bought a mandibular advancement device (a boil-and-bite mouthguard) and sleep tape, but none of these has worked either. His wife has convinced him to see you to get a formal diagnosis and treatment.
Background
- Prediabetes, diagnosed 7 years ago.
- Hypertension diagnosed 4 years ago.
- Progressive weight gain for approximately 15 years.
- Never smoked.
- Family history of Type 2 Diabetes – both parents.
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