Friday, March 14, 2014

Wake up before it's too late


A sleep disorder, or somnipathy, is a medical disorder of the sleep patterns of a person or animal. Some sleep disorders are serious enough to interfere with normal physical, mental, social and emotional functioning. Polysomnography is a test commonly ordered for some sleep disorders.



Disruptions in sleep can be caused by a variety of issues, from teeth grinding (bruxism) to night terrors.
  • Insomnia When a person suffers from difficulty falling asleep and staying asleep with no obvious cause, it is referred to as.
  • Dyssomnia refers to a group of sleep disorders with the symptoms of trouble falling asleep or maintaining sleep, which may cause an elevated sense of sleepiness during the day.
  • Delayed sleep phase disorder (DSPD): inability to awaken and fall asleep at socially acceptable times but no problem with sleep maintenance, a disorder of circadian rhythms.
  • Advanced sleep phase disorder (ASPD), non-24-hour sleep–wake disorder (non-24), and irregular sleep wake rhythm, all much less common than DSPD, as well as the transient jet lag and shift work sleep disorder.
  • Sleep apnea a.k.a obstructive sleep apnea: Obstruction of the airway during sleep, causing lack of sufficient deep sleep, often accompanied by snoring. Other forms of sleep apnea are less common. When air is blocked from entering into the lungs, the individual unconsciously gasps for air and sleep is disturbed. Stops of breathing of at least ten seconds, 30 times within seven hours of sleep, classifies as apnea. Other forms of sleep apnea include central sleep apnea and sleep-related hypoventilation.
Today we will learn more about Sleep Apnea and tell how the problem is easy to address once the first step of consulting the doctor is done!

According to Dr. H. B. Chandrashekar, Director Jain Institute of Pulmonary and Sleep Medicine the diagnosis of sleep apnea is based on the conjoint evaluation of clinical symptoms (e.g. excessive daytime sleepiness and fatigue) and of the results of a formal sleep study (polysomnography, or reduced channels home based test). 


This helps in establishing an "objective" diagnosis indicator linked to the quantity of apneic events per hour of sleep (Apnea Hypopnea Index(AHI), or Respiratory Disturbance Index (RDI)), associated to a formal threshold, above which a patient is considered as suffering from sleep apnea, and the severity of their sleep apnea can then be quantified. Mild OSA (Obstructive Sleep Apneas) ranges from 5 to 14.9 events per hour of sleep, moderate OSA falls in the range of 15–29.9 events per hour of sleep, and severe OSA would be a patient having over 30 events per hour of sleep.

Treatment often starts with behavioral therapy. Many patients are told to avoid alcohol, sleeping pills, and other sedatives, which can relax throat muscles, contributing to the collapse of the airway at night. As sleep apnea is inherently worse in the supine position for many patients (positional sleep apnea), sleeping on one's side is often advised.

For moderate to severe sleep apnea, the most common treatment is the use of a Continuous Positive Airway Pressure (CPAP) device which 'splints' the patient's airway open during sleep by means of a flow of pressurized air into the throat. 


The patient typically wears a plastic facial mask, which is connected by a flexible tube to a small bedside CPAP machine. The CPAP machine generates the required air pressure to keep the patient's airways open during sleep. While pure CPAP machines require one to input a desired pressure (usually determined in an overnight sleep study), an APAP machine will automatically titrate the air pressure as needed to minimize apneas and hypopneas. Advanced models may warm or humidify the air and monitor the patient's breathing to ensure proper treatment.


Although CPAP therapy is extremely effective in reducing apneas and less expensive than other treatments, some patients find it extremely uncomfortable. Many patients refuse to continue the therapy or fail to use their CPAP machines on a nightly basis, especially in the long term. One way to ensure CPAP therapy remains comfortable and effective for patients is to carefully consider the right CPAP face mask to be used. CPAP masks come in different shapes, sizes and materials to ensure effective treatment for obstructive sleep apnea. It is important to select the right mask to fit each patient.


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