Though most prevalent of sleep-oriented disorders, sleep apnoea is underdiagnosed and potentially life threatening ailment. Boski Gupta delves into the process of identifying the problem and fighting it out
Recently, a report suggested that actor Carrie Fisher’s death was a result of sleep apnoea, among other factors. Though we cannot ignore these other factors which include the use of narcotics, sleep apnoea has become a dangerous reality in our day-to-day stressful lives. According a study conducted by Philips Healthcare and Blue Caterpillar, more than 53% of people in India suffer from sleep apnoea while a significant number of patients are unaware of their condition. While many people may ignore snoring – and some may also take it a sign of peaceful sleep – it’s just one of the symptoms which maybe indicating you to take the right steps towards your health.
What’s sleep apnoea?
“Sleep apnoea is a common and serious sleep disorder. It occurs when person’s breathing is interrupted during sleep. Sleep apnoea literally means ‘no breath’ or ‘stopping breathing’ during sleep. Air stops flowing to your lungs for 10 seconds or longer – that is, the person actually stops breathing,” says Dr Sonam Solanki Jain from Nightingales Home Healthcare Services while Dr Manvir Bhatia, senior neurologist and author of The Sleep Solution explains, “There is narrowing of the breathing passage leading to partial or complete closure with a drop in oxygen and change in pattern of sleep. This occurs a few 100 times at night.” It is a disorder characterised by airway collapse (behind the tongue) during sleep, and is associated with comorbidities like hypertension, diabetes, stroke, and has both short and long term consequences on one’s health.
Identify, and make haste
Though both the doctors agree that the end result of all the sleep disorders is that the body’s natural cycle of slumber and daytime wakefulness is disrupted, Dr Bhatia adds, “Main reasons can be due to overweight, narrow airway or small jaw, family history, nasal obstruction.” Dr Solanki Jain also agrees sleep disorders can be genetic.
Everyone can experiences sleep problem from time to time. But Dr Solanki Jain advises to keep track of sleep habits by maintaining a diary. “If you fall asleep while driving or sitting ideal, or you struggle to stay awake when inactive, such as watching television or reading, or have performance problems at work or find it hard to concentrate or even slow responses can mean that you should see a doctor immediately.”
Solution at hand
Dr Bhatia says, “The most important thing is to find out the cause, site of blockage, extent or severity of the problem.” Diagnosis is done by Polysomnography Test, Electroencephalogram Test, and Genetic blood test. According to the severity of the condition, the doctor may go for general measures like weight loss therapy in case of obese patients, or sleeping in lateral position, avoiding alcohol, sleep medications, caffeine and nicotine etc. In case of severe problems the doctor may prescribe Pap (Positive Air Pressure). This is a device which delivers air under pressure to open the airway, and is used every night; it also helps in improving snoring and daytime tiredness. “Some cases with a mild disease may also be given dental device and few may be candidates for nasal surgery,” says Dr Bhatia.
Technology, the bane
Along with blaming our sedentary lifestyle Dr Solanki Jain also points out that technology is stealing our sleeping habits. “People love to use electronic gadgets in the bedroom. Our phones, tablets, computers and electronic gadgets have become such an important part of our daily lives that it’s often hard to put them down even at bedtime,” she says adding, “Lights emitted the devices restrain the production of melatonin (hormone which controls our sleep/wake cycles). Reducing melatonin makes us harder to fall and stay asleep. Games, Movies, and e-mails keep your brain active and engaged. Technology can trick our brain into thinking that it needs to stay awake.”
But the same technology is also coming to the rescue of the patients. “Philips has introduced a fully integrated, patient-centric sleep therapy solution featuring connected positive airway pressure (PAP) therapy device, complementary mask line, and engagement tools to improve care for obstructive sleep apnoea (OSA) patients,” says Priyank Aggarwal, head of strategy and direct 2 patient businesses, Philips (India).
In some cases, specialists recommend a continuous positive airway pressure (CPAP) machine for people suffering from sleep apnoea. “A CPAP (Continuous Positive Airway Pressure) machine treats OSA by providing a flow of air through a facial mask to keep the airway open during sleep. We understand that it’s not easy to sleep with cumbersome masks and devices but these are increasingly becoming comfortable to use with improvements in technology, and especially the patient interface which is now light weight, built with better quality material, smaller in size and is battery operated,” says Aggarwal.
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Major symptoms of sleep apnoea
- Loud Snoring, interrupted by pauses in breathing (apnea)
- Excessive daytime sleepiness, tiredness on waking up
- Gasping or choking during sleep
- Memory loss, Poor judgement/concentration
- Mood changes-irritability, Depression
- Repeatedly going to the bathroom at night
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- Fix a bedtime and wake-up time. Maintain a regular time to wake up, even on days off work and on weekends
- Minimise lights, noise and extremes in temperature in the bedroom
- Avoid napping during the daytime, if daytime sleepiness becomes overwhelming, limit nap time to a single nap of less than one hour
- Avoid caffeine, nicotine, alcohol
- Do regular exercise, but avoid strenuous exercise close to bedtime
- Maintain body weight according to the height
- Avoid using computers, internet, video-games close to bedtime-switch off all these at least 1.5-2 hrs before bedtime
- Establish a regular relaxing bedtime routine