Sleep Interrupted

Obstructive sleep apnea (OSA) is one of the common and unrecognized diseases in our community. In the U.S.  an estimated 25% of the adult population has symptoms suggestive of OSA. Our regional data suggests higher rates of OSA as a result of the higher obesity rates. In Saudi Arabia almost 33% of adult males have the symptoms and the risks for having OSA. Characterized by cessation of breath caused by repetitive episodes of upper airway obstruction that occur during sleep,  repeated episodes are usually associated with a reduction in blood oxygen saturation and fragmentation of sleep. Factors that predispose to OSA include obesity, excess tissue in the airway, large tonsils, a large tongue and some abnormal facial and jaw structure.

Patients with OSA usually present with excessive daytime sleepiness, un-refreshing sleep, morning headaches and excessive mouth dryness. They’re frequently told by their bed-partner that they snore and in some occasions they can witness the apnea episodes and report it to the physician. Other symptoms include restless sleep, heartburn, decreased libido, frequent urination at night and lack of concentration and cognitive function.

It is a potentially life-threatening condition that requires immediate medical attention. The risks of undiagnosed OSA include heart attacks, uncontrolled high blood pressure, strokes, impotence, irregular heartbeat, and heart disease. Additionally, the excessive daytime sleepiness can result in major car or occupational accidents, lost productivity and interpersonal relationship problems.

  

The diagnosis of OSA requires a sleep test called polysomnography, or sleep study. This overnight sleep test that involves monitoring brain waves, muscle tension, eye movement, respiration, oxygen level in the blood and audio monitoring, and provides comprehensive qualitative and quantitative view about a patient’s sleep and any associated breathing abnormalities during sleep.

Mild OSA is usually treated by some behavioral changes like weight loss and avoiding supine position when asleep. Dental devices that help in bringing the jaw forward are also used for mild OSA.   Moderate to severe OSA is usually treated with a machine that blows air into the nose via a nasal mask, keeping the airway open and unobstructed. It’s called C-PAP (continuous positive airway pressure), proven to be effective in managing OSA and reducing the risk for future complications that are known to results from untreated OSA.

Dr. Suhaila Al Jawder [MD, MRCP] is a Consultant of Pulmonology & Sleep Lab at Royal Bahrain Hospital. To book your appointment call 17246800 or visit www.royalbahrainhospital.com for more information