Sunday 4 December 2011

Obstructive Sleep Apnea: You Never Know If You Are Next In the Queue

By Douglas Kidder


The tendency to shun bad news is common. When someone complains of the distress experienced due to obstructive sleep apnea, somewhere deep down in our minds, we feel that such illnesses are not going to knock on our doors. We shut our eyes and ears to the extent that we do not bother to know what the illness is all about, what the signs are and most importantly, how they treat such a condition.

What is the condition all about?

Sleep apnea is undoubtedly one of the most disabling and distressful sleep disorders that happen when snoring is left untreated. It is caused by narrowing of the upper airways that causes major breathing impedance. Recurrent breathing pauses make sleeping practically impossible. A single pause could last for about 10 seconds or more; if the condition is serious there could be 5 to 30 pauses in an hour, repeated many times throughout the night.

There are three types of this disorder, of which the obstructive type is most prevalent, affecting close to 70% of people diagnosed with the condition. It happens when there is a complete collapse and blockage of the upper respiratory tract.

Are you at risk?

Your risk potential is high if you are male, 50+, obese and also snore loudly and persistently. According to official statistics, males are more at risk than females. Risk increases in proportion to degree of obesity. If you are suffering from heart ailments, you run a higher risk. Statistics mention that 60% of all such people even suffer strokes as a consequence of the disorder.

Sleep apnea symptoms: how do you know about its onset?

Catching the features of the illness is difficult since most of them show up during sleep. This makes the condition one of the most undiagnosed health issues. The signs that are noticed by the bed partner are:

- Loud and persistent snoring that refuses to get cured with conventional snoring remedies.

- Choking and gasping during sleep.

- Pauses between snoring; the patient seems to have stopped breathing during these phases.

- Chokes and gasps during sleep

The patient ultimately notices these features:

- Excessive daytime sleepiness. This is an important indicator since average snoring does not cause daytime tiredness.

- Quick and irrational weight gain

- Sore throat, dry mouth on waking up

- Morning headaches

- Mood deterioration like depression, irritability, etc.

- Concentration problems

- Daytime fatigue, depression, irritability, etc.

Avoiding misdiagnosis

This disorder tends to get misdiagnosed due to the presence of some overlapping signs. For example, daytime sleepiness is one of the leading narcolepsy symptoms and also present in hypersomnia.

Chances of misdiagnosis can be averted if certain other differentiators are kept in mind. For instance, narcolepsy has another tell-tale sign: sudden sleep attacks. This feature clearly puts it in a separate class. Likewise, the age of onset for apnea is around 50 years of age; other sleep disorders set in earlier.

Sleep apnea treatment

Therapeutic strategies depend entirely on the severity of the condition. If the condition is mild, doctors first try to provide relief from snoring by changing some lifestyle habits like quitting alcohol, changing sleeping posture, raising pillow height, etc. Use of specially designed sleep apnea pillows is also popular. For restoration of pause-free breathing, CPAP therapy is effective.

Surgery however is the last and final option for managing severe obstructive sleep apnea. There are several options in this including genioglossus advancement; mandibular myotomy, tracheotomy, uvulo-palato-pharyngoplasty (UPPP), laser assisted uvuloplasty (LAUP), hyoid suspension; maxillomandibular surgery; and bariatric surgery.




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