Sleep Apnoea Treatment by Dr. Shalabh Sharma
ENT service

Obstructive Sleep Apnoea Syndrome (OSAS)

OSAS is a disease in which the patient’s breathing stops repeatedly while sleeping at night. Usually, OSAS patients are heavy snorers whose partner observes that they stop breathing at night (the snoring stops) and seem to be in distress while asleep. Due to the multiple breaks in the sleep pattern, the patients do not feel refreshed in the morning on waking up, feel sleepy and tired in the daytime & fall asleep easily if someone else is driving the car. OSAS is known to contribute to high blood pressure, puts a strain on the heart, and is suspected to have a role in brain strokes and heart attacks that take place at night while sleeping.

Diagnosis is confirmed and the severity is quantified by a test called the sleep study. This test can be carried out overnight in a hospital or even at the patient’s home. The report includes details of the sleep pattern of the person along with various parameters such as blood oxygen levels, heart rate etc. The depth of sleep is also recorded, as this is vital. Break in the depth of sleep is responsible for the poor quality of sleep and the daytime feeling of sleepiness. A second part of the study also looks at the beneficial effect of the use of a high air pressure device called a CPAP, which is a mask tightly worn by the person while sleeping. This improves the quantity of air reaching the lungs and in turn, the quality of sleep.

Treatment is lifestyle modification to include weight loss by a combination of diet control with exercise. However, this helps patients to some extent, but is difficult for any person to lose the 10-20kgs or even more required depending on how much they are overweight for their height. This also does not work in patients who are slim and not overweight.

Surgical treatment is also a good option as many obstructive pathologies can be corrected. This usually leads to a good improvement in snoring as well as some improvement in sleep apnoea. The patient should have a discussion with the surgeon regarding the expected benefits.

The surgeries may include Nasal Septoplasty, Coblation® ("COBLATION is a registered trademark of Arthrocare Corporation, a subsidiary of Smith and Nephew, Inc. The mark COBLATION is being referred to only as a technology for conducting ENT surgeries and all intellectual property rights vest with the registered proprietor".) assisted Inferior Turbinate Reduction, Palatoplasty, Pharyngoplasty, Tonsillectomy or Base of Tongue Reduction.

Key words : OSAS, Sleep apnoea, Obstructive sleep apnoea syndrome, Palatoplasty, Coblation, Snoring

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