Sleep apnoea is more than just a snoring problem; it's a serious sleep disorder that interrupts breathing during sleep. These interruptions, known as apnoeas, can last for several seconds to minutes and occur multiple times per hour. This disorder, which affects millions globally, often goes unnoticed until it significantly impacts a person's quality of life. It can lead to health issues, such as daytime fatigue and cardiovascular problems. This article delves into the intricacies of sleep apnoea, focusing on the diagnostic methods and treatment options available through ENT specialists. We spoke to our expert Dr Smita Nagaonkar, Consultant and Section Co-Ordinator, ENT, Sir HN Reliance Foundation Hospital, Mumbai, who shared insights on the same.
Symptoms Of Sleep Apnoea
“Symptoms of sleep apnoea include loud snoring, gasping for air during sleep, frequent awakenings, and excessive daytime sleepiness. Conditions associated with OSA also include breathing pauses or short breaths while sleeping due to upper airway obstruction. These disruptions may occur several times during the night, lasting from a few seconds to several minutes,” said Dr Nagaonkar.
Types Of Sleep Apnoea
Generally, sleep apnoea is categorised into two main types. Dr Sundari explained each one of them as follows:
Obstructive Sleep Apnoea (OSA)
It is caused by the relaxation of throat muscles which leads to blockage of the airways during sleep. According to StatPearls, using the criteria of five or more events per hour, OSA impacts nearly 1 billion people worldwide. Of these, 425 million adults aged 30-69 suffer from moderate to severe OSA, defined as 15 or more events per hour. The growing prevalence of OSA is linked to rising obesity rates, which range from 14-55%. Additionally, certain risk factors, such as obesity and the structure of upper airway soft tissues, have a genetic component.
Some of the factors contributing to this ailment are as follows:
- Obesity
- Deviated nasal septum with sinusitis
- Nasal polyps
- Cho Amal adenoids with enlarged tonsils
- Narrow nasopharyngeal passages due to enlarged pharyngeal muscles and tubal tonsils
- Crowded oropharynx receding chin with macroglossia (huge tongue)
- Flappy epiglottis
Also Read: Expert Shares How Obstructive Sleep Apnoea Affects Women Differently Than Men
Central Sleep Apnoea (CSA)
“This happens when the brain doesn’t send the right signals to the muscles that control breathing. Unlike OSA, it's not caused by a blockage but by a communication problem between the brain and breathing muscles,” added Dr Nagaonkar.
How to Mitigate and Cure OSA Symptoms in Adults?
Given the potential for severe health consequences, it is vital to seek medical attention if sleep apnoea is suspected. Thus, ENT specialists play a significant role in diagnosing sleep apnoea and primarily undertake a comprehensive diagnostic process. Dr Nagaonkar listed important measures that you should follow:
- Medical History and Symptoms Review: The ENT specialists assess with a detailed medical history and symptom review, focusing on snoring, daytime sleepiness, and difficulty breathing during sleep. Patients with medical histories of obesity, hypertension, respiratory disorders and cardiovascular diseases may be more prone to developing OSA.
- Physical Examination: A comprehensive examination of the nasal passages, throat, and mouth is crucial for diagnosing potential blockages. Common issues linked to sleep apnoea include enlarged tonsils, adenoids, and nasal polyps (sinuses).
- Sleep Studies: Polysomnography (sleep study), is a diagnostic tool used to assess sleep patterns, respiratory function, and oxygen saturation. Home sleep apnoea tests are also available for an initial evaluation of sleep disorders and can be useful for preliminary diagnosis.
- Imaging and Endoscopy: In certain cases, imaging techniques, such as X-rays, CT scans, or MRIs are employed to gain a detailed view. Such diagnosis can provide detailed images of the airway structures, helping to pinpoint obstructions or anomalies.
Also Read: Sleep Apnoea VS Insomnia: Expert Explains The Difference Between The Two
Treatment Options for Sleep Apnoea
Treatment options for sleep apnoea may differ based on the severity of the condition and the underlying causes. Thus, ENT specialists frequently suggest this treatment as an initial step:
Lifestyle Changes
"Weight loss, quitting smoking, and positional therapy can significantly reduce the severity of sleep apnoea. Positional therapies for OSA are designed to discourage patients from sleeping on their backs and encourage side sleeping instead," said Dr Nagaonkar.
Medications
While there are no specific medications for sleep apnoea, managing related conditions, such as nasal congestion with medications can improve symptoms.
Positive Airway Pressure (PAP) Therapy
“Continuous Positive Airway Pressure (CPAP) is the most common and effective treatment for moderate to severe OSA. It involves using a mask that delivers continuous air pressure, keeping the airway open while sleeping,” added Dr Nagaonkar.
Surgery
In cases where lifestyle changes and CPAP therapy are ineffective, surgical options may be considered. ENT surgeons can perform various procedures, including:
- Uvulopalatopharyngoplasty (UPPP): It removes excessive tissues from the throat to widen the airway.
- Genioglossus Advancement (GA): It involves shifting the attachment of the tongue muscle to prevent the airway from collapsing.
- Maxillomandibular Advancement (MMA): It is a procedure that repositions the upper and lower jaws to enlarge the airway.
- Inspire Therapy: It includes a surgically implanted device that stimulates the hypoglossal nerve, to keep the airway open during sleep.
- Oral Appliances: For some patients, especially those with mild to moderate sleep apnoea, dental devices that reposition the lower jaw and tongue can be effective.
Bottomline
Dr Nagaonkar concluded, “Better sleep is fundamental for maintaining physical health, mental well-being, cognitive function, and overall quality of life. Prioritising good sleep hygiene and addressing sleep disorders can lead to significant improvements in health and daily functioning.”
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your own professional if you are dealing with any health issues to avoid complications.]