People still don't admit they snore. It can have adverse health effects
'Snoring per se may be harmless, but when you can't breathe while you are snoring, that can be a sign of a more serious disease,' said Dr Anant Mohan, a decorated pulmonologist from AIIMS, Delhi.
New Delhi: Over 58 per cent of Indians consider snoring an indicator of good sleep. This myth was busted at a recent gathering of doctors. They helped people understand the health risks associated with undiagnosed Obstructive Sleep Apnea.
OSA is a sleep disturbance with repeated episodes of upper airway obstruction.
'There is a blockage of oxygen, you gasp for a bit, then go back to sleep. This happens again—you do the same and go back to sleep. The cycle continues throughout the night,' said Dr Mohan, referring to the Quiet Sleep Epidemic that most Indians don't address.
Five eminent medical consultants from AIIMS, Delhi, were part of a panel discussion titled Beyond the noise: Snoring—A wake up call for your health. The panel discussion moderated by Dr Alok Thakar, Professor and head of department of ENT & Head and Neck surgery, included Dr Mohan, Dr Rakesh Kumar, Professor of ENT & Head and Neck Surgery, Dr Achal Kumar Srivastava, Professor of Neurology and Dr Nitish Naik, Professor of Cardiology. The panel discussion was curated and chaired by Dr Ashwini Kumar.
Fragmented sleep not only translates to just waking up groggy, zoning out during the day. Over time, it can lead to serious complications.
'It can lead to memory impairment, trouble concentrating, depression, anxiety, hypertension, heart diseases, to ultimately dangerous things like stroke and sudden death. It's a dangerous disorder,' said Dr Thakar.
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From diagnosis to acceptance
Snoring alone doesn't mean one is suffering from OSA. The panel explained how one should go about, if there are signs of trouble. An ENT or a general physician should reasonably be able to detect the disorder.
'It is a cumbersome test, but unfortunately, Polysomnography (sleep study) is the gold standard for diagnosing OSA,' said Dr Srivastava. It is an overnight monitoring of your sleep. Sensors are attached to one's body tracking brain activity, eye movements, muscle tone, breathing, snoring, body movements and heart rhythm.
The doctors warned against screening tools, like questionnaires, found on the internet. 'People are now looking at apps, putting monitoring devices under the mattress to pick up the sensation and record all body movements. But none of them can diagnose OSA to the level we want,' said Dr Mohan.
Dr Kumar highlighted the stigma around snoring.
'Acceptance is not easy. Getting a person to admit that he's a heavy snorer is not easy, there's a stigma there,' said Dr Kumar.
CPAP (Continuous Positive Airway Pressure) therapy is effective for OSA, but there is aversion on the patient's part to continue with the treatment.
CPAP therapy delivers continuous air pressure through a tight-fitting mask to keep the upper airway open during sleep, preventing episodes of breathing obstruction.
'As soon as they are advised of the CPAP therapy, people don't want to use it,' said Dr Kumar.
The mask is a significant commitment for patients. 'It is virtually a lifelong therapy,' added Dr Kumar.
Also read: Your sleep problems may not be a lifestyle issue but a medical one
Surgical intervention
The panel of doctors informed the audience that there is no oral medication to treat OSA.
Dr Mohan said the only effective treatment is a combination of CPAP therapy and weight loss.
'Most patients discontinue CPAP therapy within a month or by the end of one year, and then what they want is an easy option out; they feel surgery is an answer. Unless we know where the problem is, the surgery will not be 100 per cent effective,' said Dr Naik.
OSA is a multi-faceted problem. 'There are many sites where breathing is obstructed. If only one side is obstructed, surgery will be effective. If there are obstructions at multiple sites, we have to decide on the least invasive surgical intervention. I usually don't advise multi-level surgery,' said Dr Naik.
Dr Mohan stressed the need for weight management to counter the condition and aid treatment.
'There are masks, nasal pillows, and then there is a helmet. However, if you are dramatically overweight, many of these treatments would not be effective,' said Dr Mohan.
(Edited by Theres Sudeep)
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