Current Medicine Research and Practice (Jan 2012)
Obstructive sleep apnoea in adults
Abstract
Obstructive sleep apnoea (OSA) is a sleep-related breathing disorder (SRBD) which is common, yet under-reported even in developed countries. It usually starts with snoring which is considered a benign problem essentially with nuisance value. However, the onset of daytime sleepiness points to the more severe part of the spectrum of SRBDs. All patients with habitual loud snoring and signs or symptoms of OSA should be referred to a sleep disorders centre for an evaluation and a polysomnography study. A comprehensive sleep evaluation is generally recommended as one-fourth of patients can have a combination of sleep disorders. The impact of OSA on the other body systems especially cardiovascular morbidity has to be emphasized. The effects of untreated OSA and excessive daytime sleepiness on mental health and work efficiency as well as increased accident risk should not be undermined. The SRBD continuum can be effectively treated by non-invasive techniques, continuous positive airway pressure (CPAP) therapy being the gold standard. Other devices such as bilevel positive airway pressure (BiPAP), nasal expiratory positive airway pressure (EPAP) and oral appliances may be used where indicated. Regular follow-up is required to troubleshoot new problems, to reinforce daily use and to be certain that the CPAP is effective. Surgical options may be explored, if there is no relief or intolerance to these measures. However, surgery is likely to correct snoring but may not completely eliminate apnoea or hypopnea and its associated morbidities. Om pranasyedam vashe sarvam Tridive yath pratiptitam Matheva putran rakshasva Shreescha pranjnaascha videhi na ithi Om shantih shantih shantihi —Pranayam mantra by Patanjali Yoga [Prana the vital force pervades all the three worlds (below the earth, the earth and above the earth) All the activities are directed by prana To that very prana we request to protect us as a mother protects her children We also request the prana to stimulate our intellect]
