sleep apnoea ,snoring and sleep related disorders
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Sleep apnoea ,snoring and
sleep related disordersDR DEBASISH DATTA MAJUMDERM.S, MRCS (Edin), DOHNS ( England)
Consultant ENT and Head Neck Surgery
Columbia Asia Hospital,Whitefield
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What is Sleep apnoea??
Apnoea: Cessation of breathing
During sleep
Periods when your breathing stops for
10 seconds or more when you sleep.
Brief spells of wakefulness which the
individual is not aware of.
Disturbed sleep.
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Obstructive Sleep apnoea
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What Happens?
Throat muscles become so relaxedand floppy during sleep that they
cause a narrowing or even a complete
blockage of the airway. If the passage is narrow it produces
snoring
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What Happens??
Complete blockage :then your breathingactually stops (apnoea) for around 10seconds.
Your blood oxygen level then goes down and
this is detected by your brain. Your brain then tells you to wake up and you
make an extra effort to breathe. you start to breathe again with a few deep
breaths. You will normally go back off to sleep again
quickly and will not even be aware that youhave woken up.
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Ask your spouse
you stop breathing for a short time,
then make a loud snore and a snort,
perhaps even sound as if you are
briefly choking, briefly wake up, and then get straight
back off to sleep.
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When do we call it OSA
You need to have at least fiveepisodes of apnoea events per hour of
sleep.
Mild OSA - between 5-14 episodes anhour.
Moderate OSA - between 15-30
episodes an hour. Severe OSA - more than 30 episodes
an hour.
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Consequenses
Daytime sleepiness. This is often differentto just being tired. People with severe OSA
may fall asleep during the day, with serious
consequences. For example, when driving,
Poor concentration and mental functioning
during the day. This can lead to problems at
work.
Not feeling refreshed on waking.
Morning headaches.
Depression.
Being irritable during the day.
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Risks
High Blood Pressure
Heart Attack
Stroke
Death
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Who are predisposed?
Overweight and obesity, particularly if youhave a thick neck,
Drinking alcoholin the evening. Alcoholrelaxes muscles more than usual and makesthe brain less responsive an apnoea episode.
Enlarged tonsils.
Taking sedative drugs such as sleepingtablets or tranquilisers.
Sleeping on your back rather than on yourside.
Having a small or receding lower jaw (a jawthat is set back further than normal).
Smoking.
http://www.patient.co.uk/health/Alcohol-and-Sensible-Drinking.htmhttp://www.patient.co.uk/health/smoking-the-factshttp://www.patient.co.uk/health/smoking-the-factshttp://www.patient.co.uk/health/Alcohol-and-Sensible-Drinking.htm -
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So What can be done??
Lifestyle modifications: a) Losing weight if you are obese
b) Not drinking alcohol for 4-6
hoursbefore going to bed.
c) Not using sedative drugs.
d) Stopping smoking if you are asmoker.
e) Sleeping on your side and in asemi-
propped position.
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Surgery
Correction of crooked nasal partitionwall
Tonsil and adenoids surgery
Uvulopalatoplasty
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GOLD STANDARD
CPAP
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