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Do you wake up as sleepy as you were before you went to bed?

Has your spouse moved to the next room because of your snoring and gasping/choking at night?

If so, it could be obstructive sleep apnoea (OSA).

Sleep Apnoea refers to a cessation of breathing during sleep of at least ten seconds. In obstructive sleep apnoea the patient typically stops breathing from 5 to even 100 times a night, waking up for a couple of seconds each time to gasp for air.

The lack of oxygen, and too much carbon dioxide in the blood stream has deleterious effects on the health. Cumulatively this can cause a gradual but significant deterioration in someone’s quality of life, typically over months and years.

OSA sufferers also have an increased risk of hypertension and stroke.

Causes

  • Narrow airway
  • Short neck
  • Small chin
  • Jaw deformities
  • Obesity
  • Large tongue
  • Higher incidence of OSA in smokers and heavy drinkers.

Symptoms include

  • Excessive daytime sleepiness, including nodding off at work or at the wheel.
  • Morning headaches
  • Irritability
  • Snoring
  • Gasp or choking during sleep
  • Intellectual deterioration

Diagnosis

70% of OSA sufferers are obese, however the other 30% aren’t, and it is important to be vigilant for the possibility of OSA in a person with a normal body mass index.

Your clinician will most importantly take a sleep and lifestyle history, followed by an assessment of your body habitus, neck, ears, nose and throat

If there is suspicion of sleep apnoea, your doctor will arrange for you to have sleep study (Polysomnogram) conducted overnight at a local sleep research unit.

Management

  • Sleep Hygiene
  • Airway management with the help of CPAP machines
  • Weight loss if overweight
  • Avoid sleeping on back. Side sleeping preferable. One possible technique is to sew a tennis ball onto the back of a night shirt to discourage laying flat.
  • Nasal decongestant sprays and antidepressants may be prescribed by your clinician to help manage the condition.
  • Surgery is available as a last resort.

A note about children

Sleep apnoea occurs in 1-3% of children 2-8 years old, especially in the obese or those who snore. They will require a more detailed work up and it is important to check with your family doctor if you suspect your child may not be breathing properly while asleep.

Take a step towards better health by checking in with your family doctor at CHI about any concerns you may have.

To a good night’s rest!

Dr Cheryl Kam
MBBS BSc GDFM
Complete Healthcare International Pte Ltd

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