In Obstructive sleep Apnea

Dr Shubha Agrawal • MD CHEST & TB(K.E.M .Mum)

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•AGRAWAL DIAGNOSTIC CENTRE

WHAT IS SNORING A rough, rattling, inspiratory noise produced

by vibration of the pendulous palate, or sometimes of the vocal cords during sleep .

As patient doze off and progress from a lighter sleep to a deep sleep, the muscles in the roof of the mouth (soft palate), tongue and throat relax.

If the tissues in the throat relax enough, they vibrate and may partially obstruct the airway.

The more narrowed airway, the more forceful the airflow becomes and louder snoring.

Snoring may be an occasional problem, or it may be habitual. Loud and frequent snoring can be more than just a nuisance to patient’s partner.

This nighttime annoyance may indicate a serious health condition, and it can disrupt household and strain relationships.

Snoring is common. More than one-third of adults snore at least a few nights each week.

What contributes to snoring in Sleep Apnea :- Sedative pills, drugs abusers Mouth anatomy. Alcohol consumption. Nasal problems. Hypothyroid. Smoking Obesity Deviated Nasal Septum

Effects of snoring in sleep apnea • Daytime sleepiness• Morning headache• Poor concentration • Memory loss• Excessive night sweat • Decrease sexual desire• Nocturnal awakening• Resistant obesity • Hypertension• Diabetes • Heart attacks ,brain stroke

OSA IN CHILDREN• Bedwetting• Choking or drooling• Excessive sweating at night• Restless in bed• Learning and behavioral disorders• Poor school performance• Sluggishness or sleepiness• Snoring• Teeth grinding

SCREENING & DIAGNOSIS Physical examination and Medical history. His partner may need to answer some questions

about when and how he snore to help doctor assess the severity of the problem.

Parents are asked about the severity of a child's snoring.

Pulmonologist sleep disorder specialist & ENT consultation for additional studies and evaluation will be helpful.

Home Respiratory sleep study with titration can be done or can be done at hospital for in depth analysis of sleep disorder.

•Traffic Accidents due to sleep

EVALUATION

Sleep Study PFT Pathology X-Ray ECG Sleep Endoscopy CT Scan / MRI

INTEGRATED YOGA MODULE FOR SNORING

Breathing practices Hands stretch breathing Dog breathing Tiger breathing Tongue massaging Tongue in and out Tongue rotation Bhramari Lip stretch

TREATMENT First recommends lifestyle changes, such as losing

weight, avoiding alcohol close to bedtime and changing sleeping positions ,reduction in weight and stop nicotine consumption .

If lifestyle changes don't eliminate snoring: Continuous positive airway pressure (CPAP).Oral appliances. Traditional surgery / uvulopalatopharyngoplasty

(UPPP). Laser surgery. Radio frequency tissue ablation (somnoplasty).

Continuous positive airway pressure (CPAP) machine to eliminate snoring and prevent sleep apnea. A CPAP machine

delivers just enough air pressure to keep the upper airway passages open.

Heavy snorers have their air flow impeded by the structures at the back of the mouth and nose (A and B), which can be alleviated by surgery.

In UPPP, the patient's uvula, soft palate, and tonsils are removed (C and D).