Good night’s sleep is key to good health
Obstructive sleep apnoea occurs when there are repeated episodes of complete or partial blockage of the upper airway during sleep. The cessation of breath can reduce the flow of oxygen into the body and cause irregular heart rhythms
Obstructive Sleep Apnoea (OSA) is a disease which is fast becoming a ‘Silent Killer’ in our country. Actually this is quite a paradox because the patient actually makes a lot of noise when s/he is snoring. It is termed ‘silent’ because nobody attributes death directly to OSA but the patient dies due to its consequences which are increased risk of heart attack, stroke (brain attack), increased blood pressure, diabetes, thyroid disease, weight gain, etc. The patient might be involved in accidents leading to loss of ones own life but also of others, especially if they are drivers or pilots.
As the name suggests, OSA occurs due to an obstruction in the path of air entering into the lungs of the patient while s/he is asleep. The obstruction lies in the nose, the palate or the tongue and more commonly is a mixture of all of these. As a result the level of oxygen in the blood decreases, which leads the patient to fall asleep. Consequently, the body does not get enough rest and oxygen. This can be observed typically by an increasing level of snoring followed by a total cessation of breathing for some time and a gasp with which the patient again starts breathing. The patient wakes up groggy and keeps on falling asleep during the day as well. Such people need help.
Snoring is a progressive disorder; it will only increase with time if no intervention is instituted. One third of people, who snore, eventually end up having OSA. There are a lot of other factors, which add to this problem, obesity being a major one. Our populace is becoming more obese due to unhealthy food habits and lack of exercise. Stress and a disordered or decreased sleep time leads to non-restful sleep. Smoking and regular alcohol consumption can further complicate matters.
So far, the only treatment available for OSA was to breathe through a CPAP machine while sleeping. Good results, however, have been seen recently with some new surgical procedures. They are clubbed together under the name of ‘multi-level snoring and sleep apnoea surgery’. Although, the first step to get treatment is to get a sleep study (Polysomnography) done. This test is done while the patient sleeps and tells about the severity of his/her OSA.
All patients of OSA should have their ENT examination done, for that reveals the possible sites of obstruction of the airway. Patients will be benefitted with the help of a CPAP machine. But many patients,
especially those with obvious nasal problems, do not tolerate the CPAP machine well and should be advised only after the nasal problem has been corrected. Other patients may not like the fact that they have to carry the machine wherever they go, especially those with a travelling job. Still others may find the machine claustrophobic.Till now patients had no other option. A series of patients, who have been operated recently, had a good relief from their snoring and OSA. Some of them have even been taken off their CPAP machines. Carefully selected procedures are carried out on the nose, palate and tongue, which free the airway from obstruction as a one-time surgery. There are various procedures present and their combination depends on the individual anatomical structure of the patient.
As the OSA improves, various medical risks associated with it are also reversed and the patient is alert during the day and his/her quality of life improves. To maintain the benefits of the operation it is necessary that the patient brings about lifestyle modifications and makes sure that the weight does not increase. Once the patient sleeps better s/he feels more motivated to exercise and lose weight.
Factors Contributing to OSA
• Nasal allergy and sinusitis
• Deviated nasal septum
• Large tongue
• Small jaw
• Thick and long soft palate