Sleep apnoea ,snoring and

sleep related disorders

DR DEBASISH DATTA MAJUMDER
M.S, MRCS (Edin), DOHNS ( England)
Consultant ENT and Head Neck Surgery
Columbia Asia Hospital,Whitefield
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.
Obstructive Sleep apnoea
What Happens?
Throat muscles become so relaxed
and floppy during sleep that they
cause a narrowing or even a complete
blockage of the airway.
If the passage is narrow it produces
snoring

What Happens??
Complete blockage :then your breathing
actually stops (apnoea) for around 10
seconds.
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 you
have woken up.

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.

When do we call it OSA
You need to have at least five
episodes of apnoea events per hour of
sleep.
Mild OSA - between 5-14 episodes an
hour.
Moderate OSA - between 15-30
episodes an hour.
Severe OSA - more than 30 episodes
an hour.

Consequenses
Daytime sleepiness. This is often different
to 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.

Risks
High Blood Pressure
Heart Attack
Stroke
Death
Who are predisposed?
Overweight and obesity, particularly if you
have a thick neck,
Drinking alcohol in the evening. Alcohol
relaxes muscles more than usual and makes
the brain less responsive an apnoea episode.
Enlarged tonsils.
Taking sedative drugs such as sleeping
tablets or tranquilisers.
Sleeping on your back rather than on your
side.
Having a small or receding lower jaw (a jaw
that is set back further than normal).
Smoking.

So What can be done??
Lifestyle modifications:
a) Losing weight if you are obese
b) Not drinking alcohol for 4-6
hours
before going to bed.
c) Not using sedative drugs.
d) Stopping smoking if you are a
smoker.
e) Sleeping on your side and in a
semi-
propped position.

Surgery
Correction of crooked nasal partition
wall
Tonsil and adenoids surgery
Uvulopalatoplasty
GOLD STANDARD
CPAP