Obstructive Sleep Apnoea
November, 2020
Regular and sufficient good-quality sleep is of vital importance to maintain healthy physical and mental health. Sleeping is like getting your body recharged for the next day. "OSA (Obstructive sleep apnoea) is hugely underdiagnosed condition even today"
Sleep disordered breathing
Unfortunately, sleep disorders go unnoticed both by patients and their clinicians very often in clinical practice. Most people know when to seek medical help for physical discomfort such as fever or pain, but the same is not true about sleep related disorders such as Obstructive Sleep Apnoea (OSA). OSA is the most common sleep-disordered breathing observed in clinical practice.Obstructive Sleep Apnoea is characterised by partial or complete collapse of the airways causing intermittent hypoxia during the sleep. This leads to disruption of normal sleep resulting in excessive daytime sleepiness to compensate for the lost sleep in the night. It may also lead to a variety of symptoms starting from morning headaches, reduced cognitive performance, resistant hypertension, vehicle accidents during one of the irresistible naps during driving. Sleep disordered breathing can be diagnosed with overnight polysomnography or sleep study.
Sleep study or polysomnography can be conducted either in hospital or at home. It is a non-invasive overnight examination which monitors thoracic and abdominal respiratory efforts, nasal ow, ECG, EEG, oxygen saturation and body movements throughout the sleep. It also has a microphone to record snoring. The data collected digitally in the overnight sleep is analysed by the sleep specialist next day. After analysis of data collected, sleep specialists can give a diagnosis of the type of sleep disordered breathing and guide treatment.
Moderate to severe severity of OSA can be with CPAP device. Other approaches include surgical correction on the advice of ENT or maxillofacial surgeons. Treatment of underlying abnormalities such as obesity, hypothyroidism, retrognathia etc also helps in reducing OSA symptoms.
Indications for sleep study
Common indications for sleep study / polysomnography:
Polysomnography or sleep study is indicated in following subset of patients- Patients of with excessive daytime sleepiness or insomnia
- Heavy snoring associated with observed apnoea and/or excessive daytime sleepiness along with
Resistant hypertension
- Atrial fibrillation
- Unexplained pulmonary hypertension
- Patients with chest-wall and neuromuscular diseases whose illness is complicated by chronic hypoventilation, polycythaemia, pulmonary hypertension, disturbed sleep, morning headaches, or daytime somnolence and fatigue
- Patients with COPD whose awake PaO2 is > 55 torr with pulmonary hypertension, right heart failure, polycythaemia, or excessive daytime sleepiness