Snoring-Risk To The Life

Sleep is necessity not a luxury:

During sleep, brain is highly active. It regulates immune, hormone and endocrine functions. Good sleep is essential for general health; it ultimately restores good memory, learning process, problem solving ability and creativity. Most adults sleep 6 – 8 hours in the nighttime and duration varies from individual to individual. Sleep less than 4 hours and more than 9 hours have bad effects on the health. During sleep we go through NREM (Non rapid eye movement) and REM (Rapid eye movement) stages.

Sleep deprivation due to snoring leads to daytime sleepiness. This dangerous medical condition often goes undiagnosed and people are unaware about the consequences.

Recent study shows that 34% of the male and 10% female are habitual snorers. Intermittent snorers, 56% are male and 30% are female. Snoring increases with the age. As snoring leads to daytime sleepiness, in India one out of 19 Indians go to sleep when they are sitting. Obviously they are suffering from Sleep Apnoea.

Obese men are more prone for snoring and may have Obstructive Sleep Apnoea (OSA) and more prone to Heart attack.

If somebody snores excessively during sleep, we have feeling that his sleep is nice and symbol of happy person. Now, you should not take snoring during sleep lightly. In long run he or she may suffer from Sleep Apnoea which have many known, recognized and unrecognized like threatening consequences.

Untreated cases can lead to uncontrolled hypertension mostly in young age and can have arrythmias ultimately causing heart attack and stroke.

There is increased risk for Diabetes, Thyroid dysfunction, Obesity, Acidity, Impaired concentration and memory leading to daytime sleepiness. These people, because of daytime sleepiness and lack of concentration, are more prone for automobile accident, accident at work places, financial losses and loss of work.

Snoring leads to pauses in the breathing called as “Apnoea”. During apnoea patients are without breathing. These pauses “Apnoea” can be for 10 seconds to 1 or 2 minutes in duration. These pauses are potential risk to the life and if not, can cause lots of metabolic changes in the body, like irregular heartbeats, changes in the blood pressure, oxygen de-saturation i.e., less oxygen being provided to brain, heart and other body tissues. Oxygen de-saturation or more carbon dioxide accumulation in the body is potential risk to life.

In OSA what happens during the night sleep

• Snoring during sleep
• Apnoeic pauses during breathing
• Gasping or chocking during sleep
• Fragmented sleep
• Excess urination during night
• Excessive perspiration during sleep
• Fragmentation and loss of architecture of sleep

Daytime these peoples have

• • Morning tiredness and Headache
  • Needs nap during day

Excessive daytime sleepiness with fatigue

• Memory loss and poor concentration
• Impaired daytime performance
• Irritability and moodiness
• Depression, change of personality
• Chest pain, Breathlessness
• Impotence

Why OSA ( Obstructive Sleep Apnoea ) happens ?

Mostly in snorers and obese peoples, during sleep, muscles, which control the tongue and soft palate, become relaxed and the upper airway can, become completely blocked and prevent the normal breathing.

Risk factors for Sleep Apnoea

• History of snoring
• Obesity
• Increased neck circumference
• Family History
• Narrowed upper airways
• Hypothyroidism
• Acromegaly

In one of the current study in USA, 28% of the truck drivers were found to have mild sleep apnoea. As the automobile accidents are more common in sleep apnoea patients, drivers need to be routinely screened for both, sleep apnoea and for the impaired performance.

In India it is seen that 3.6 % of the Indian Population (36 million people) suffer from sleep apnoea. Millions of Indian may not be aware about this problem and condition, which may have life threatening effects on their health. Sleep apnoea can cause high blood pressure, heart attack, stroke, psychological problem, obesity, compromised immune system and risk for accidents.

Good sleep or sleep hygiene can make this patient comfortable up to some extent.

• Adopt healthy and athletic life style
• Avoid sleeping tablets
• Stop tobacco chewing
• Stop Bidi / Cigarette smoking
• Discourage alcohol
• Maintain sleep hygiene as regular schedule
• Set aside worries
• Keep sleeping room cool, dark, quiet

How to diagnose Sleep Apnoea

Many of the features and interview with patients & spouse or partner along with physical examination can make the diagnosis obvious. But the gold standard for the diagnosis is still Polysomnography or sleep study.

Polysomnography or sleep study is performed during the night time and it gives idea about the severity of OSA, whether it is mild, moderate or severe, apneas are centrally origin or obstructive in nature. Severity of snoring, severity of apneas, heartrate, body oxygen saturation, body movement, chest and abdominal movements, effects of sleep apnea on brain, heart and various parts of the body is recorded during sleep study. It is helpful in rectifying the defects.

Overall 90% of the people suffering from sleep apnoea do not know what problem they have.

Usually a bed partner first notices it. Once the diagnosis is made then they are treated with surgical management or non-surgical management like CPAP.

Health Consequences of Sleep Apnoea

• Chronic sleep deprivation
• Excessive daytime sleepiness
• Increased Motor vehicle accident
• Poor job performance
• Increased work related accident
• Family discord
• Decrease in quality of life
• Impaired cognitive function
• Decreased survival

Studies

• Study reports that natural death during sleep in elderly may be associated with sleep apnoea
• Strong relationship between sleep apnoea & heart failure
• Strong relationship between sleep apnoea & essential hypertension, Diabetes Mellitus
• Sleep Apnoea is risk factor for development of stroke
• This patient also have risk during Anaesthetia, during Surgery & during Recovery period from surgery

In summary it is always better for snorers to get their health check up for sleep apnoea at sleep study centers and take early measures to prevent further complications and consequences for sleep apnoea.