By Dr Karl Mehta
Are you a person aged between 30 to 70 years, who are overweight, who snores in their sleep, who is experiencing tiredness and easy fatiguability? If your answers to these questions are mostly Yes, then you may be suffering from a condition called Obstructive Sleep Apnoea (OSA).
OSA is a condition where increased relaxation of your throat muscles during sleep results in reduced oxygen supply to the brain with subsequent increase in one’s heart rate eventually causes the persons brain to wake up from sleep. Repeated arousals of the brain due to the lack of oxygen supply eventually causes damage to the brain resulting in: feeling tired, sleepy, moody, frequent headaches reduces the ability to concentrate and creates memory problems.
Why are we creating awareness about OSA? It is because studies have determined that undiagnosed and untreated cases of sleep apnoea were directly correlated to the increase in road traffic accidents. A person with OSA, who was behind the steering wheel, was not alert of their surroundings.
Did you know that undiagnosed and untreated sleep apnoea is known to worsen existing comorbidities like diabetes mellitus – inadequate control; cardiovascular disease, recurrent heart failure; worsening high blood pressure, worsening obesity despite reduced and controlled diet; and strokes in young adults.
Well, correct diagnosis and adherence to treatment and therapeutic strategies are known to improve the patient’s: sleep, energy levels, exercise tolerance, reduce the number of medications required, decreases the frequency of hospitalizations and hospital visits. These actions cumulatively improve the patient’s quality of life and well-being.
How do we diagnose patients to have OSA? We do so by performing a Polysomnography i.e. overnight sleep and titration studies. Once diagnosed, patients are classified into mild, moderate, and severe disorder.
Treatment of OSA is multifactorial but primarily entails the use of non-invasive positive pressure ventilation (NIPPV) via continuous positive airway pressure (CPAP) or bilevel positive airway pressure device. These machines pump in the air at the pressure required to open the airway allowing adequate inflow of oxygen. Adequate oxygenation prevents arousals and allows the patient to rest the brain and body. This enables the body to replenish depleted energy stores, which in turn improves alertness, activity, energy, and a person’s frame of mind.
Can OSA be overcome? Well, it depends on the patient’s severity of OSA, state of mind, discipline and motivation. Usually, patients with mild OSA where obesity is the primary cause can do so by strictly adhering to regular use of NIV therapy, along with regular diet and exercise for significant weight loss. It will require a complete change in a person’s lifestyle.
What are the outcomes for people with OSA & Diabetes? With adherence to NIPPV therapy, improved sleep quality over the long haul has been shown to reduce the doses required, dependence on insulin may reduce and may prevent or delay the onset of insulin resistance.
What are the outcomes for people with OSA & Hypertension? The decrease in the number of antihypertensives required delays the onset of right heart failure, markedly reduces the incidence of recurrent heart failure, reduces the risk for developing ischemic heart disease… etc. If you can relate to this article, then why not take a step back, take a look in the mirror, be honest with yourself and look to seek help from a qualified Pulmonologist.
About the author:
Dr Karl Mehta is a Consultant Pulmonologist & Sleep Specialist from Bengaluru.
