Consultancy Corner: Timely attention to apnea can ease sleep disorder

If you have answered ‘yes’ for few of these questions, then you are among one in 10 Indians who may have obstructive sleep apnea (OSA). Apnea literally means ‘no breath’. Obstruction of the upper airway can occur repeatedly during sleep causing reduced oxygen entry into the lungs.  This in turn decreases the oxygen concentration in the blood and makes the heart do more work to increase the blood supply to other vital organs. The person literally has to ‘wake up’ and breathe more to overcome the obstruction. 

OSA can lead to conditions like high blood pressure, diabetes mellitus, heart diseases, reduced sex drive, headaches, mood swings and much more. With disturbed sleep during the night, the person’s concentration gets impaired during the day.  Individual sleep requirements vary between people. On an average, an adult human would need at least seven to nine hours of sleep every day. Unfortunately, OSA is under recognised, though fairly prevalent.  

It is frequently found in obese people, though this is not a strict rule. Men are twice at risk than women. Cigarette smoking, alcohol, sedatives, sleeping on the back rather than the side can contribute to OSA. 

The most common symptom of OSA is excessive day time sleepiness. Affected people fall asleep in ‘inappropriate situations’ — in meetings, post- lunch, while waiting at traffic lights, etc. Excessive snoring and ‘apneas’ are the other symptoms.  

However, it is important to understand that snoring alone does not mean that there is OSA. If you experience these symptoms seek medical help. The doctor will most likely order a sleep study — Polysomnogram (PSG), that electronically records your brain waves (Electroencephalogram), heart rhythm (Electrocardiogram), air flow oxygen saturation, muscle tone, eye movements and also snoring with a microphone. 

This would be an overnight study done in specialised sleep laboratories and during certain situations, could be done in homes as well. 

Once OSA is diagnosed, the patient will require treatment with positive airway pressure (CPAP) while sleeping. CPAP is delivered by a ventilator (usually portable) through a tight fitting face mask where air is pumped forcefully into the patient’s airway. 

There are many types of masks to suit individual requirement. Subsequently, a second, night sleep study would be required to find the optimum pressure to be set in the CPAP machine, since the levels of obstruction would vary in different people. Compliance with the treatment is vital for successful treatment of OSA. 

Few patients with advanced obstruction may be referred for surgery. Weight reduction and cessation of smoking and alcohol are important in the treatment of OSA. Complications from untreated OSA can be very serious and can be easily prevented by treating OSA, and it is essential to recognise the symptoms early and consult a doctor. 

As a wise man once said, “Prevention is always better then cure.” This ancient quote still holds good today.