Obstructive Sleep Apnea (OSA) is a kind of sleep disorder where a person’s breathing stops involuntarily due to over-relaxation of throat muscles. Such pauses in breath occur multiple times throughout the night leading to disrupted and poor-quality sleep.
“OSA is present in the general population, but awareness level is very low. One must not ignore this health issue. It is seen more in obese people, those who have short neck, lot of fat around the neck and back. Whenever they lie down, while sleeping the air passage collapses due to too much fat, which leads to snoring. Suddenly these passages close due to lack of air supply into the lungs,” Head of Pulmonary Medicine department at Goa Medical College and Hospital (GMCH), Dr Uday Kakodkar said.
Due to this situation, the patient suddenly wakes up. He then has disturbed sleep at night. When this situation continues for a long duration, the patients develop lot of problems like dozing off while talking, lack of concentration and irritability.
“Because of the OSA the patients tend to become hypertensive, many are diabetic. They tend to honk in traffic jam because they are irritated. Their entire ear, nose, throat (ENT) component should be checked, their thyroid test needs to be done. They have to undergo a test called Polysomnography, also called a sleep study. It is a comprehensive test used to diagnose sleep disorders,” Dr Kakodkar said.
Dr Kakodkar informed that a sleep laboratory is coming up at the GMCH to conduct sleep studies. “For conducting sleep study, we use a machine called Polysomnograph that records all the activities while sleeping. It is the component of a sleep laboratory where all the situations like number of instances of absence in breathing, low breathing. Depending upon the score, we decide whether the problem is mild, moderate or serious. We are coming up with such a laboratory at GMCH. We are setting up the necessary infrastructure and it will be open for public soon,” he said.
Senior pulmonologist from Margao, Dr Pravin Bhatt said the incidence of OSA in Goa is not different from the situation in country. “Some of the patients coming to us have problem of snoring and have a disturbed sleep, it means there are apneic episodes occurring,” Dr Bhatt said.
“Most of these patients complain of dozing in the day. Sometimes they have hypersomsolence, which is excessive sleepiness. They wake up for frequent urination, have lot of lethargy and can’t concentrate on their work due to lack of sleep. It does not allow you to have rapid eye movement sleep during early morning when one sees dreams. If you don’t get into that stage, the whole sleep is wasted,” the pulmonologist said.
People suffering from OSA don’t get oxygen in their brain. One can have a cardiac arrest or even have a brain stroke.
“One of my patients having OSA had committed multiple minor accidents. These patients are not supposed to drive unless they really get the treatment. Those working in factories face life risk due to drowsiness,” he said.
Interventional Pulmonologist at Manipal Hospitals Goa, Dr Prabhu Prasad N.C. said that it is not necessary that all OSA patients have to be obese.
“If the air passage is already compromised due to co-morbidities like obesity, asthma one is more prone to have sleep apnea. People with high blood pressure requiring more than two medications to control BP and unexplained heart attacks and stroke should be thoroughly screened for OSA at the earliest and get treated. As per the data by Indian Sleep Registry, two to three per cent of OSA has been detected in the population. We have been OSA in mostly affluent patients who have a sedentary lifestyle,” the pulmonologist said.
Pediatric pulmonologist Dr Barnali Bhattacharya said that even children are prone to OSA and should be screened thoroughly.
“OSA is common in children too. We have to examine children who are snoring, for enlarged adenoid. These children can have apnea in sleep. While in adults obesity is a major reason for OSA, in children Adenoidal hypertrophy (or enlarged adenoids), which is the unusual enlargement of the adenoids, which can happen due to infection or allergy,” Dr Bhattacharya said.
“In children, first line of treatment for OSA if it is due to allergic rhinitis, is treating the condition. But if it is due to adenoidal hypertrophy, the children will need surgery. Most children’s OSA gets managed by treating their allergic rhinitis. Some need surgery (removal of adenoids and tonsils), a very small percentage who have congenical syndrome where muscle tone is very poor, may need BiPAP or CPAP (home ventilators) machines, like adults with OSA,” she said.