Do you snore loudly at night, wake up gasping for breath, or feel unusually tired even after getting enough hours of sleep? These could be warning signs of Obstructive Sleep Apnea (OSA), a common sleep-related breathing disorder that is often overlooked.
OSA occurs when the muscles of the throat relax during sleep, partially or completely blocking the upper airway. This can cause breathing to stop and restart repeatedly during the night, disrupting sleep and reducing oxygen levels.
The condition is a significant health concern in India.
Dr. Abhilash Reddy Venna, MBBS, DTCD, DNB Respiratory Medicine (NIMS), EDARM (Switzerland), Fellowship in Interventional Pulmonology (NMC, Japan), Consultant Clinical & Interventional Pulmonologist, Sri Sri Holistic Hospitals, Kondapur, throws light on the causes, warning signs, risk factors, diagnosis, treatment options, and potential health complications associated with Obstructive Sleep Apnea (OSA).
What Is Obstructive Sleep Apnea?
Obstructive Sleep Apnea is a condition in which the throat narrows or becomes blocked repeatedly while a person is asleep. Each interruption may last several seconds and can occur many times during the night.
The Apnea-Hypopnea Index, or AHI, is commonly used to assess the severity of OSA. An AHI of 5 to less than 15 is generally considered mild, 15 to 30 moderate, and above 30 severe.
Because these interruptions repeatedly disturb normal sleep, a person may wake up briefly without even remembering it the next morning.
What Are the Warning Signs?
Loud, persistent snoring is one of the most common symptoms, but not everyone who snores has OSA.
Other warning signs include:
- Pauses in breathing noticed by a partner
- Waking up choking, gasping or short of breath
- Excessive daytime sleepiness
- Morning headaches
- Dry mouth or sore throat after waking
- Difficulty concentrating or remembering things
- Irritability or mood changes
- Feeling unrefreshed despite adequate sleep
Daytime sleepiness can also increase the risk of accidents, particularly while driving or operating machinery.
Who Is at Greater Risk?
OSA can affect people of different ages, but the risk increases with certain factors. Excess body weight is an important risk factor because tissue around the upper airway can contribute to narrowing.
Other factors include:
- A large neck circumference
- Upper airway / facial anatomy
- Gender (more common in males)
- Genetic factors / Family history
- Certain genetic disorders
- Hypothyroidism
- Polycyclic ovarian syndrome (PCOS)
- Alcohol consumption / Sedative usage
Men are generally more likely to develop OSA than women, although OSA can affect women too and may sometimes be less easily recognised.
How Is OSA Diagnosed?
- A proper medical evaluation is important because snoring or daytime tiredness alone cannot confirm OSA.
- Doctors may assess symptoms, medical history, physical features and risk factors before recommending a sleep study (polysomnography).
- Depending on the individual, testing may involve an overnight sleep study in a sleep centre or home sleep study test.
- The results help determine whether OSA is present and how severe it is, allowing treatment to be tailored to the individual.
How Is Obstructive Sleep Apnea Treated?
- Treatment depends on the severity of OSA, symptoms, and the person’s overall health.
- Lifestyle changes can be helpful, particularly maintaining a healthy weight, exercising regularly, sleeping on the side when appropriate, and avoiding alcohol or sedative medicines that may worsen airway collapse.
- For many adults with clinically significant OSA, Positive Airway Pressure therapy is an important treatment. CPAP delivers a continuous flow of air through a mask to help keep the airway open during sleep.
- Clinical guidelines recommend PAP therapy for appropriate adults with OSA, particularly those experiencing excessive daytime sleepiness or impaired quality of life.
- Some people may also benefit from custom oral appliances. In selected cases, surgical procedures or other specialised treatments may be considered.
Why Should OSA Not Be Ignored?
Untreated OSA can affect much more than sleep. Repeated breathing interruptions and oxygen fluctuations are associated with problems such as high blood pressure, cardiovascular diseases, impaired concentration, cerebrovascular accidents (stroke) and diabetes mellitus.
The good news is that OSA can be diagnosed and managed effectively. Recognising persistent snoring, breathing pauses, and excessive daytime sleepiness early can be an important step towards better sleep and better overall health.
If you or someone in your family regularly snores loudly, stops breathing during sleep, wakes up gasping or feels excessively sleepy during the day, it is worth discussing these symptoms with a qualified healthcare professional.
