Don't take snoring lightly, it could be signs of serious health issues, warn UAE doctors

Snoring is often ignored by people as a harmless sleeping habit, but beware, it could be a sign of serious health problems, as it's the main reason for Obstructive Sleep Apnea.

The recent death of veteran Indian music composer and singer, Bappi Lahiri, has put the spotlight on Obstructive Sleep Apnea (OSA). Experts says the medical condition should be checked out and have urged residents to monitor their sleep patterns.

Dr Meenu Cherian, ENT Specialist, Thumbay University Hospital explained that (OSA) is a commonly under-diagnosed disorder found among overweight people. It is caused by the repetitive collapse of the upper respiratory passage during sleep and this causes a partial or complete breathing obstruction.

“The obstruction can occur at the level of the nose, nasopharynx, Oropharynx, hypopharynx, mandible or neck. An affected person presents with snoring, disturbed sleep with episodes of choking or gasping, daytime irritability, loss of concentration at work or school and morning fatigue due to excessive daytime sleepiness,” explained Dr Cherian.

Dr Hardik Patel, specialist pulmonologist, NMC Royal Hospital DIP, Dubai said that the word apnea comes from Greek word ‘apnos’ meaning absence of breathing and is associated with collapsing of airways while the patient is asleep.

“This in turn leads to a snoring sound which is generated due to turbulent airflow through the narrowed airway. Though a very common phenomenon, snoring is usually attributed to nasal obstruction by many, leading to delayed diagnosis of the disorder and inadvertently leading to significant impact on quality of life of the patient,” said Dr Patel.

“Continued respiratory effort and disturbed sleep leads to low oxygen levels in the blood. Prolonged obstruction could lead to pulmonary or systemic hypertension, cardiac arrhythmias, congestive cardiac failure and other heart conditions like myocardial infarction etc,” added Dr Cherian.

Memory loss, morning headaches, mood swings, depression are some of the other conditions people suffer due to OSA, medicos said.

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Case Study report:

Dr Ppatel explained a case study of a 64-year-old female, presented with complaints of severe headaches, especially in the mornings after waking up.

"She also complained of daytime somnolence and inability to focus on daily activities. She was morbidly obese and was a snorer. On presentation it was surprising to find that her oxygen saturation was only 80% on room air. She had already adapted to being hypoxemic and had a hypoxic respiratory drive which was allowing her to maintain her minimal functionality.

"We gave her oxygen supplementation in a way that would not totally counteract her hypoxic respiratory drive and targeted a saturation of 88%. We did a polysomnography and found that the patient had an AHI of 55.2 which indicates severe Obstructive Sleep Apnea. A titration study was done next day to extract information about the pressures that were required to be maintained. A CPAP was prescribed to her, and within the next two days, she was up and about with nasal oxygen and was absolutely free of her symptoms. Thus, an overnight CPAP gave the patient the functionality and quality of life she had lost more than 8 years ago."

How common is the disorder

Doctors said that weight loss with diet and exercise could help reduce the problem but they recommend going to a specialist to get a complete clinical examination and fibre-optic nasopharyngo-laryngoscopy done to check the anatomical level of sleep-related breathing abnormalities.

“Sleep study or nocturnal polysomnography is recommended to confirm the presence and severity of the obstruction. The degree of hypoxemia, hypercapnia, inspiratory flow limitation and the number of arousal episodes are measured during the study,” said Dr Cherian.

“Site specific surgical therapy (nasal/ palatal / hypo pharyngeal or base of tongue) or staged surgical management (if obstruction is at more than one anatomical level in the upper respiratory tract) may be needed with improvement in the condition,” he added.

ayaz@khaleejtimes.com

• Dubai