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Consultancy Corner: Occurence of sleep apnea high in obese people

Sleep apnea is a potentially serious disorder in which the abrupt cessation of breathing can cause choking and airway compromise.

Consultancy Corner: Occurence of sleep apnea high in obese people
Dr Sundhari Veluchamy, ENT Specialist, Kauvery Hospital


When the airway becomes completely blocked, there is no breathing for 10-20 seconds, and then the brain senses the apnea and signals to wake up to breathe. This pause in breathing is known as apnea. This process continues hundreds of times throughout the night, the individual experiencing the apnea is not conscious of the problem.

There is a significant increase in the number of people who are obese; and those who are affected by sleep disturbances and snoring.

Snoring is one of the signs of sleep apnea followed by silent breathing pauses and choking or gasping sounds. It can also cause dry mouth or throat irritation, headache, fatigue with mental irritability due to inability to concentrate at work, and excessive daytime sleepiness.

Sleep Apnea is a serious sleep disorder and a risk factor for heart disease, stroke, diabetes and many other health problems. It can occur in males and females and kids of all ages, obese or Non-obese peoples, but the risk of sleep apnea is higher in overweight people with a body mass index (BMI) of more than 30. Additionally, the size of the neck is also one of the factors which can cause snoring, short neck with excessive fat stores around the neck will restrict the airway and cause loud snoring.

Central sleep apnea occurs when your brain doesn’t send proper signals to the muscles. This causes irregular rhythm of breathing. and can cause sudden cardiac arrest, due to constant lowering of oxygen levels. Another major side effect of sleep apnea is due to excessive day time sleepiness.

As per the airway compromise and metabolic causes, sleep apnea can be classified into three types:

  • Obstructive Sleep Apnea with loud snoring which is the most common; this is due to the mechanical obstruction and narrowing of the nasal and oropharyngeal airway.
  • Central Sleep Apnea, which occurs due to the brain not sending proper signals to the muscles that control breathing.
  • Complex Sleep Apnea syndrome, occurs when someone has a mix of both obstructive sleep apnea and central sleep apnea.

What are the factors causing the sleep apnea?

Sleep apnea can occur due to multiple factors, the most common is mechanical obstruction of nasal passage due to nasal septum deviation with enlarged tonsils, thickened and elongated Uvula causing the airway to be narrow.

How to diagnose sleep apnea?

An expert otolaryngologist or sleep physician can diagnose and treat sleep apnea. Evaluation will be done by getting the detailed history and as per the subjective score of Epworth sleepiness scale questionnaire, the condition will be diagnosed that the patient suffers from definite sleep disorder with excessive daytime sleepiness. Both nasal and oro-pharyngeal endoscopic examination can evaluate the mechanical obstruction. By using Mallampati score technique, grading of the obstruction can be done. Sleep Apnea can be confirmed by radiological images of Computerized CT scans or Dynamic sleep MRI scans.

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