Sleep

What is obstructive sleep apnea?

What is obstructive sleep apnea?

Singer and music composer Bappi Lahiri (69) died Tuesday evening following complications from Obstructive sleep apnea (OSA), drawing attention to a widely prevalent but underdiagnosed medical condition. OSA is a disorder in which a person’s breathing repeatedly stops and starts again during sleep.

After hearing the news of the singer’s death, the 45-year-old woman’s husband insisted she see a doctor and was diagnosed with OSA on Thursday. In fact, several doctors in Delhi have reported an increase in queries about the disease.

What is Obstructive Sleep Apnea or OSA?

Obstructive sleep apnea occurs when muscles in the throat and upper airways relax intermittently during sleep and block the airway. “It usually happens in obese men, less commonly in women, but it does happen. When a person is obese, they develop excess fat on their larynx and pharynx (throat muscles) which can block their airways breathing during sleep The muscles start to relax during sleep and it’s a situation like a garden hose, you know, when there’s no water it flattens out and no air can pass,” said Dr Nevin Kishore, head of bronchology at Max Hospital, Saket.

He said: ‘When air doesn’t get into the lungs, oxygen saturation starts to drop. When it’s critical, the brain wakes the person up. They wake up unconsciously, breathing resumes. And this cycle keeps repeating itself all night long.

Although the disease does not kill on its own, it can lead to heart attacks and strokes due to low oxygen levels. In the long term, it can also lead to increased blood pressure, abnormal heart rhythms, and other metabolic disorders. This further leads to an increase in obesity, which compounds the problem.

OSA also leads to many road accidents, as people with OSA tend to doze off while driving. “OSA is the most common cause of motor vehicle crashes in the United States,” said Dr. GC Khilnani, former chief of the department of pulmonology and sleep medicine at the Institute of Medical Sciences of the United States. India and currently President of the PSRI Institute of Pulmonary, Critical Care and Sleep Medicine.

It can also lead to depression.

What is its frequency? And is it underdiagnosed?

The prevalence of OSA is 4% in women and 13.4% in men, Dr. Khilnani said.

The prevalence in people under 40 is around 10% and in those over 40 it is 17%. “It’s quite common. A hospital the size of, say, 300 to 500 beds, probably sees around 12 to 15 cases every day, especially in places like Delhi where awareness is higher. More cases could be seen in hospitals with dedicated sleep medicine departments. In fact, at any one time, about 40 of the patients in my intensive care unit have OSA as well as other conditions,” said Dr. Sumit Ray, Chief of Critical Care Department at Holy Family Hospital.

However, it is underdiagnosed. Dr Khilnani said: “OSA as a medical condition has only been recognized for 40 or 50 years. When I was a medical student, we didn’t study about it. When we were young, we used to say that he who snores enjoys a good sleep. But this is not the case.”

“It is underdiagnosed, especially in smaller towns. Moreover, most of the symptoms like snoring and choking are usually noticed by the partner, but many Indian brides don’t even complain about it,” he added.

When should you go to a doctor?

Snoring is one of the most common symptoms of OSAS, but not everyone who snores has it. Dr. Kishore says nine out of 10 people who snore don’t have the condition, but you should definitely see the doctor if you feel groggy or sleepy in the morning and doze off during the day.

To check if someone has OSA, doctors look for something they call the “STOP BANG.”

“S – Do you snore while you sleep? T – Are you TIRED when you wake up or for most of your day? (This happens because patients with OSA have very little restful sleep) O – Has anyone OBSERVED you having fits of choking while you were sleeping? P – Do you have high blood pressure,” says Dr. Abhishek Tandon, a specialist in pulmonary and sleep medicine at the ‘AIIMS Jodhpur, on Twitter.

He adds: “B – Is your BMI (body mass index) > 35? A – Is your AGE > 50 years old? N – Is your neck circumference > 40 cm? G – Is your GENDER male or are you postmenopausal female? If your answer to > 5 of the 8 questions listed above is YES, you are at high risk of having OSA! »

If you think you have the condition, see your GP or ENT specialist.

Whether you have OSA is determined by doing a sleep study in a hospital or even at your home. The test is available in most major hospitals and costs Rs 10,000 to Rs 20,000.

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How can OSAS be treated or controlled?

The prevalence of OSA in India goes hand in hand with the rise in obesity, and doctors believe the best way to reduce OSA symptoms is to lose weight.

“Studies have shown that a 10% increase in body weight increases the incidence of OSA sixfold. However, if patients lose 10% weight, the incidence decreases by 20%,” Dr Ray said. Alcohol consumption also increases symptoms and should be avoided at night by those with OSA.

When it comes to treatment, the best method is to use CPAP (Continuous Positive Airway Pressure) therapy. “It’s like letting the water run through the garden hose to help it hold the structure together,” Dr Kishore said. The sleep test also tells doctors how much pressure is needed to maintain the airways.

Additionally, some surgeries may be offered if there are structural abnormalities in the mouth. “Uvulopalatopharyngoplasty (surgery to open up the upper airway by removing extra tissue from the throat) doesn’t really treat sleep apnea, it just reduces snoring,” Dr. Kishore said.