Snoring - Sleep
Snoring - Sleep
Obstructive Sleep Apnoea
What is Obstructive Sleep Apnoea (OSA) ?
Obstructive sleep apnea (OSA) is a type of sleep disordered breathing where there are repeated episodes of Apnoea ( complete stoppage/obstruciton of breathing)complete or Hypopnoea ( partial stoppage/obstruction of breathing ). This arises due to collapse of the upper airway during sleep. This results in lowering of the blood oxygen levels. People with OSA almost always also snore.
What is the mechanism for Obstructive Sleep Apnoea ?
During sleep, the muscles relax, the airway narrows or closes as we breathe in, and breathing stops for some time. This may lower the level of oxygen in blood. Our brain senses this inability to breathe and briefly rouses us from sleep so that we can reopen airway. Once aroused, the upper airway muscle tone increases, restoring the patency of the breathing passage and resumption of breathing. This awakening is usually so brief that we don’t remember it. This repetitive process happens multiple times throughout the night. These disturbances decrease the levels of necessary deep sleep, restful phases of sleep. Because of this there is sleepy feeling during day time. People may not be aware that their sleep is interrupted. In fact, many people with this type of sleep apnoea think they sleep well during night.
What are the Symptoms of Obstructive Sleep Apnoea ?
People suffering with OSDB could have one or more of the following symptoms. If you any of these symptoms, please do not neglect them and seek the opinion of the ENT or sleep specialist :
- Fragmented sleep
- Non restful sleep
- Observation of
- Apnoea by bed partner
- Awakening with choking
- Cramps in calf muscle
- Early morning Headache
- Excess day time sleepiness
- Lack of Concentration
What are the possible consequences of Obstructive Sleep Apnoea ?
OSA is a medically serious condition and must not be taken lightly. It can have very significant health consequences if not treated timely. Some of the consequences of untreated OSA include:
Hypertension ( increased blood pressure)
Cardiovascular Problems – Heart failure , Irregular heart rhythms
Myocardial Infarction (heart attack)
Urinary and Sexual problems
Poor Daytime functioning leading to Depression
Accidents – Driving accident due to poor concentration, sleepiness and slow reaction times
Do you think you could have SDB or OSA ?
Have a look at and fill in this scoring system (ESS). This could give you an idea if you are suffering from SDB or OSA. If so , do not delay seeing our ENT Specialist.
How do we diagnose OSDB or OSA ?
Our team of doctors will take a thorough history to understand your problem and its severity. If possible, observations of the bed partner will also be helpful. We will carry out a thorough examination of head, neck, nose and throat.
The obstruction may occur at one or more of the sites along the upper airway passages such as the nasal cavity, nasopharynx (behind the nose) , oropharynx (upper throat), hypopharynx (lower throat) , and larynx ( area of the voice box).
It is likely we will advise a flexible endoscopic examination of the nose and throat. This is a simple and routine endoscopic examination performed in the clinic itself to allow a full examination of all these areas in one sitting and thus assess the patency of your airway.
The other very important diagnostic test is an overnight sleep study or polysomnogram (PSG). This test allows us to document the presence of and assess the severity of SDB. Read more about PSG here. We often take the opinion of colleague Sleep Specialist Physician to eventually decide the best possible options and solutions for your particular problem.
Treatment Options for OSA and OSDB
As the condition is multi-factorial , so are the treatment options, and these will need to be tailored to each individual. Our team of doctors will take in to consideration all the findings from your evaluation and of all the tests , to discuss the various options suitable for each person , and help you and your partner decide the way forward. These options include:
Avoid Alcohol and sedation
CPAP / BiPAP
CPAP is considered the treatment of choice for certain patients with OSA, like those with moderate to severe OSA. This involves fitting the patient with a mask and titrate the correct air pressure needed to alleviate the respiratory events. The benefit assessment and titration is often done as part of the sleep study. Read more about here.
In some situations of snoring or mild OSA, we the doctor may discuss the option of wearing a Mandibular Advancement Device / Splint. Again , this will be decided based on the individual persons evaluation.
Surgery for SDB
For some patients, there are surgical options for snoring and sleep disordered breathing / obstructive sleep apnoea. Each person has to be assessed on his / her individual situation to help them decide if surgery is n appropriate option , what type of procedure or combination of procedures could be considered and what results to expect. Read more about it here.