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Obstructive sleep apnoea: Treatment, symptoms, advice and help

About obstructive sleep apnoea

Obstructive sleep apnoea is a significant and one of the commonest sleep disorders occurring widely in the general population. It is characterized by the obstruction of upper respiratory tract causing lack of adequate sleep. Snoring is a common finding in cases of all sleep disorders. Obesity is the most important risk factor for obstructive sleep apnoea. Thus the treatment involves a holistic approach including lifestyle changes, weight management along with standard medical treatment modality.

Obstructive sleep apnoea: Incidence, age and sex

Obstructive sleep apnoea may involve an individual of any age. It is more widespread in men than in women. The prevalence is high in middle-aged and obese men.

Signs and symptoms of obstructive sleep apnoea: Diagnosis

The disease is distinguished by repetitive pauses in the breathing cycle during sleep. The affected individual is generally unaware of this phenomenon; however it is noticed by individuals observing him/her during sleep. Snoring (turbulent sound of air resulting while passing through mouth and nose) is almost a universal symptom in this sleep disorder. The individual may experience excessive sleepiness during daytime, headache and unrefreshed feeling after getting up in the morning. This may result in decreased concentration at work, poor performance and mood changes like depression, anxiety and irritability.

The diagnosis of obstructive sleep apnoea is generally missed initially due to lack of specific signs and symptoms. The diagnosis can be confirmed by a polysomnography test which is a study of sleep cycle and pattern.

Causes and prevention of obstructive sleep apnoea

The primary cause of obstructive sleep apnoea is obstruction of upper airway tract due to laxity of the muscles which leads to obstructed airflow. This is manifested by apnoeic episodes and difficulty in breathing. Apnoea is the stoppage of airflow at the mouth, nose for more than 10 seconds. An individual with more than 5 apnoeic episodes per hour is said to have sleep apnoea. The key predisposing factors to this condition are overweight, alcohol intake and other medical conditions like diabetes, myxoedema, tonsillar hypertrophy and macroglossia (large sized tongue). Preventive measures include weight management and appropriate lifestyle changes.

Obstructive sleep apnoea: Complications

Individuals with obstructive sleep apnoea have increased risk of vehicular and industrial accidents due to sleepiness during daytime. If the disorder is left untreated or remains unnoticed then it may lead to serious complications or aggravate existing conditions such as high blood pressure, heart and brain diseases.

Obstructive sleep apnoea: Treatment

The management of obstructive sleep apnoea includes educating the patient about the illness and advising certain lifestyle changes. These lifestyle changes include cessation of smoking, limited consumption of alcohol, avoidance of sleeping pills and maintaining appropriate weight.

The primary purpose of medical treatment is to keep airway open so that breathing continues normally during sleep. Continuous Positive Airway Pressure (CPAP) is the first line of medical treatment for obstructive sleep apnoea. It is delivered by a nasal mask at night time. It keeps the throat open by maintaining correct airway pressure. Depending upon the individual’s case history and indications, some may require surgical procedures like tracheostomy to create an opening in the blocked airway for breathing or uvulopalatopharyngoplasty to prevent occlusion by removing the excess tissue from the back of the throat. Adequate treatment results in alleviating the symptoms in most of the individuals.