Articles on obstructive sleep apnea

Weight Loss Can Prevent and Cure Sleep Apnea

Ms. Swati Kapoor, Dietitian/Nutritionist
Apnea literally means "cessation of breath." If you have sleep apnea, your breath can become very shallow or you may even stop breathing while you are asleep. This state of not breathing can occur for 10 seconds in an hour, or in severe cases, the frequency of cessation of breath may further increase. The repeated episodes of apnea (lack of breathing) cause frequent night time awakening.Individuals with this disorder often complain of morning headaches, constant fatigue, and moodiness, and can fall asleep almost anywhere. More seriously, they can fall asleep even while driving. Obstructive sleep apnea is much more common in obese individuals. It is believed that the airway of obese individuals get obstructed by large tonsils, an enlarged tongue and increased fat in the neck. This presses airways when the pharyngeal (throat) muscles are relaxed during sleep. A person's neck circumference is a good predictor of sleep apnea. Obese men with a neck circumference of 17 inches or greater, and women with a neck circumference of 16 inches or greater are more likely to have sleep apnea.The worst part is that it is not only obesity that has an association with sleep apnea, but sleep apnea even results in poor sleep which increases food cravings. Lack of good quality sleep increases the chances of hormonal imbalance by increasing the level of ghrelin hormone. Ghrelin is a hormone known for its effects on appetite and disturbed levels of ghrelin hormone leads to an increased appetite which further leads to weight gain.Individuals with sleep apnea often have elevated blood pressure, high fasting glucose, and high cholesterol. Lack of sleep triggers stress hormones which stimulate the cell’s glycogen to get converted into glucose. This suppresses the function of insulin due to which blood sugar levels shoot up leading to diabetes and heart problems, all of which can worsen with further sleep deprivation. So, it's a vicious cycle. Obesity can lead to sleep apnea, which, itself, then causes derangements of hormones that control eating habits, leading to more weight gain, worsened blood pressure, glucose intolerance, worsened apnea and the cycle goes on and on.So, healthy eating with exercise leads to weight loss and not only helps in preventing such a vicious cycle of health problems but also helps in the cure of sleep apnea.

Oral Appliance Therapy for Sleep Apnea!

Dr. Shweta Dixit Chaudhary, Dentist
Oral appliance therapy is an effective treatment option for snoring and obstructive sleep apnea (OSA). A custom-fit oral sleep appliance can improve your sleep, restore your alertness and revitalize your health. About Oral Appliance Therapy:Worn only during sleep, an oral appliance fits like a sports mouth guard or an orthodontic retainer. It supports the jaw in a forward position to help maintain an open upper airway. If you and your doctor decide that oral appliance therapy is the best treatment option for you, then your doctor will write a prescription for you to receive a custom-made oral appliance. You also will receive a referral to a qualified dentist who can provide oral appliance therapy. More than 100 oral appliances have received FDA clearance. The FDA-approved treatment dental devices are indicated for mild and moderate obstructive sleep apnea, as well as for severe sleep apnea in patients who cannot tolerate CPAP (continuous positive air pressure). Your dentist will recommend the oral appliance that is best for you. Oral appliance therapy is covered by many medical insurance plans. Mechanism of action:Mandibular repositioning devices (MRDs) hold the lower jaw in a forward position during sleep. In doing so, they: Create an anterior movement of suprahyoid and genioglossus muscles. (The suprahyoid muscle widens the oesophagus during swallowing and the genioglossus muscle depresses and protrudes the tongueDecrease the gravitational effect of the tongueStretch the soft palateStabilize the mandible to the hyoid bone. (The hyoid bone attaches to the muscles of the floor of the mouth and the tongue above; to the larynx below; and to the epiglottis and pharynx behind. This results in an increase in lateral pharyngeal cross-sectional area upper airway muscle activity to prevent snoring and obstructive apneas).Advantages of Oral Appliance Therapy:Oral appliance therapy is an effective, non-invasive treatment that fits easily into your lifestyle. Patients like oral appliance therapy because it is:ComfortableEasy to wearQuietPortableConvenient for travelEasy to care forHow a Dentist Can Help: The First VisitDentists work closely with physicians to treat snoring and sleep apnea. At your first visit, your dentist will talk to you about the benefits of treatment. You also will receive information on the potential side effects and the cost of therapy. Then your dentist will conduct a complete clinical evaluation. This will include an examination of your teeth, jaw, tongue and airway, and possibly a new X-ray of your mouth. Making and Fitting Your Oral ApplianceOral appliances are customized using digital or physical impressions and models of your teeth. These models are sent to a dental lab where the appliance is made. Your dentist will adjust the appliance to maximize its comfort and effectiveness. You also will learn how to clean the oral appliance and maintain it. After this fitting, your sleep doctor may schedule you for a sleep study to verify treatment success. Follow-Up VisitsFollow-up visits with your dentist will be needed to ensure the optimal fit of the oral appliance. Effective oral appliances are always custom fit and adjusted over time to ensure maximum effectiveness. Your dentist also will schedule you for an annual assessment. These routine visits are an important part of your long-term treatment success.Living with Oral Appliance TherapyTreating snoring or obstructive sleep apnea with oral appliance therapy can help you feel like a new person. You will find that your symptoms, and your quality of life, can improve dramatically when you remain committed to your treatment and use it nightly. It is likely that you will sleep better, have more energy and feel sharper throughout the day. You may find that your bed partner begins to sleep better, too! Treating sleep apnea promotes a healthier heart, body and mind. With your dentist’s help, you can improve your sleep and your health!

Can Sleeping Help Children Lose Excess Fat?

Ms. Swati Kapoor, Dietitian/Nutritionist
Parents want their children to be physically active, mentally sharp and have healthy eating habits. But in today’s lifestyle, junk foods or fast foods have taken over much of the child’s diet, affecting their health adversely. Easy availability of unhealthy food is making it difficult for parents to manage their children’s diets. Too much junk food and too little physical activity are the frequently-cited culprits of obesity and other health related issues in children. But what about sleep?New research suggests that a moderate increase in sleep may prove effective in helping children eat less and lose weight. Researchers have found that extending sleeping hours reduced overall calorie intake and altered Leptin hormone levels associated with greater appetite control. Their results suggest that ensuring children get plenty of sleep on a regular basis may offer significant help in maintaining healthy weight and avoiding obesity.Leptin plays an important role in regulating metabolism and energy expenditure, signalling to the body that it has enough energy to function, thereby reducing appetite. Abnormal and high levels of leptin can lead to leptin resistance, with the body becoming less equipped to use the hormone effectively to regulate appetite and metabolism.Studies have also shown that insufficient sleep is linked to an increased intake of hundreds of additional calories per day. Lack of sleep has also been shown to influence the types of foods we crave, leading to changes in brain chemistry that make unhealthful foods more tempting. Obesity puts children at risk for many of the same health problems, like high blood pressure and cholesterol, increased risk of cardiovascular disease, as well as type 2 diabetes. Breathing problems, including obstructive sleep apnea, are common problems among children who are obese. Weight problems that begin during childhood and adolescence often continue till adulthood. Children who are obese are more likely to be obese as adults. They are even more likely to suffer from heart problems, diabetes and many other metabolic syndromes later in their lives.Hence sleep is a powerful therapeutic tool in controlling child obesity and other related diseases as it will help you keep a check on your child’s unhealthy cravings. Sufficient sleep will even ensure proper growth and higher immunity, leading to lower susceptibility to common ailments and diseases.

Lose Weight and Stop Snoring

Ms. Swati Kapoor, Dietitian/Nutritionist
Snoring is a result of blockage or obstruction of breathing. It is not as big a problem as it may seem but can be irritating at times when you want to sleep and the person next to you is snoring. Snoring is a sign telling us that there is a problem in breathing while one sleeps and take action in curbing the problem before it becomes big and chronic.Some people have a problem that they can not breathe during sleep due to snoring. This is called Apnea. Body takes immense pressure on the body, unable to take in oxygen properly. Hypertension, hyperactivity and heart problems are more common in people who snore. People who snore probably don't get good quality sleep due to breaks during sleep because of breathing. For people with greater difficulty in snoring can cause problems to the brain due to lack of oxygen going to it.Sleep researchers in Israel examined more than 2,000 sleep apnea patients, for example, they found that 54 percent were positional, meaning they snored only when asleep on their backs and the rest were non positional.Other studies shows weight plays a major role. According to the National Sleep Foundation, in people who are overweight, slimming down is generally the best way to cure sleep apnea and end snoring for good. People who were overweight saw reduction in snoring when they lost weight.Due to increasing obesity rates snoring is picking up with kids too which is not a healthy sign. If you snore at night then try sleeping on your side and not your back, it may help. If that is not of any help to you then reduce your weight maybe you get away with the problem and sleep tight.With the help of some breathing exercises and reducing alcohol and smoking snoring can be curbed. Sleeping on the side can help in reduction of snoring. Most importantly a healthy diet and some exercise plays a great role in maintaining a balance in the body.

Can Exercise Help You Sleep Better?

Ms. Swati Kapoor, Dietitian/Nutritionist
Many people even after sleeping for 8 hours feel sleepy and tired by mid-day. This can happen because of low quality sleep. Do you also feel the same way during the day? It might be the time to examine your lifestyle habits in terms of food and exercise. Did you know that including exercise in your daily routine can help you in getting better quality sleep. Let’s see how this actually works.According to a poll in 2013 by the National Sleep Foundation in the U.S, people who worked out or exercised regularly seemed to have better quality sleep than people who did not do any physical activity even though they said they slept well every night. If you are inactive then even starting with adding a 10 minute walk initially every day could improve your likelihood of better quality sleep. In fact, it was also found in the poll that non exercisers are at a higher risk of sleep apnea. Sleep apnea is a medical condition in which a person stops breathing during sleep. Its symptoms often include tiredness, snoring, and high blood pressure. It also increases the risk for heart disease and stroke.Not having enough sleep or lack of good quality sleep can also lead to weight gain. When you do not exercise it leads to poorer sleep which in turn makes you lethargic for the whole day and keeps your energy levels low. Therefore, not exercising and low quality sleep becomes a vicious cycle. In fact lack of sleep or lack of quality sleep will make you crave for comfort food like potato chips, ice cream, etc which in the long run will make you gain weight and attract lifestyle diseases. The major drawback of this vicious cycle is you start drinking more of tea/coffee to keep yourself going for daily activities. This adds more caffeine and sugar in your daily diet which if consumed in high quantity can affect your health adversely.To have good quality sleep, try to inculcate the following in your routine:1. Include a minimum of 30 minutes of moderate to intense physical activity in your daily routine. If you are a beginner than start with light exercises like walking or running or you can even include some other physical activities like kickboxing. But, don’t exercise at the expense of your sleep.2. Keep the environment of your bedroom calm and quiet with a comfortable mattress and pillow because this will help further relax your body and might help in improving sleep quality.3. Before going to bed relax yourself and try some meditation or deep breathing. Switch off the television or laptop at least 1 hour before going to bed or you can include some relaxing rituals like a warm bath or listening to calming music.4. Make a routine of going to bed and waking up at a same time daily. Stop spending extra time in your bed when you are already awake.5. Don’t keep your desktop, work files or TV in your bedroom.Include the above to improve sleep quality but if you are experiencing excessive daytime sleepiness, snoring, or "stop breathing" episodes in your sleep, you must get in touch with a physician for a sleep apnea screening.

Need a Way to Stop Snoring? We Give You 5 of Them!

Dr. Gulab Gupta, General Surgeon
Men or women, animals too, we all snore, period. However, if the act of snoring is regular and daily, the quality and quantity of one's sleep can be disturbing to the others around, and to you as well. Snoring leads to Poor sleep habits Daytime fatigue Irritation Health issues A FAILED MARRIAGE too! We snore -- about half of adult men snore, according to studies -- for one of two reasons. Mostly we snore because our airways narrow in sleep, creating resistance in the passageways that connect our nose and mouth to lungs. The narrower the tube, the greater amount of pressure needed to establish enough flow. The fatter we are -- and in particular, the thicker our necks -- the more pressure there is on the airways, and the more they tend to collapse as we sleep.Snoring happens when the tissues around the nasal region vibrate while we breathe in our sleep, hence the noise. If there is too much nasal and throat tissue around the throat, the individual is prone to snore more than the usual. Not only this, sometimes even the position of your tongue can play culprit- aiding snoring all the more by not allowing smooth breathing. Before we identify ways to stop snoring, here is why you snore! A study by sleep specialist Lynn A. D'Andrea, from the esteemed University of Michigan Medical School, says "Any membranous part of the airway lacking cartilaginous support, including the tongue, soft palate, uvula, tonsillar pillars and pharyngeal walls, can vibrate. When you sleep, muscle tone throughout your body decreases, or becomes hypotonic. This relaxation of the upper airway muscles during sleep may decrease the size of the airway space and cause airflow limitation and turbulence." Source: Scientificamerican.com In addition to that, weight issues, age, the body frame, sinus and nasal issues, medications, smoking, alcoholism, sleep posture etc can contribute to the pesky annoying snoring habits too. Stop Snoring With These 5 Lifestyle Habits Save your marriage, your relationship or your self-esteem and let no one put you down ever, because of your uncontrolled snoring habit! Here are a few changes to make, and with the help of a specialist, you can overcome the peril too! Get to the gym or work out at home to lose weight, which would help reduce fatty tissues in the throat. A good dose of exercises everyday would help strengthen the body, tone the throat muscles and help stop snoring too. Regular sleep patterns are a must to follow, which should be stuck to as much as possible. Ask your partner to help you out with this, buddy up and follow the same for a month at least and watch the difference. For those who live in dry climes, use an air moistener or a humidifier to keep the air around moist. Dry air can play havoc with the sleep cycle and breathing pattern. And before you sleep, a nasal decongestant to use would help clear the sinuses too. Dust your beds before you sleep; the bacteria, dust mites and other elements invisible to the eyes would be shunned away, and not allowed into the throat or the nasal tract. And while you sleep, change your position as and when possible. Your head should be four inches above the body levels to help with better breathing. Cut down on the number of smokes per day, number of glasses of wine and alcohol per session, the overuse of sleeping drugs, since they are sedatives. Sedatives do not help in attaining proper sleep, hence talk to your family doctor about the medication he provides you with- it shouldn't interfere with your sleep levels. Yes, you too can make someone's night sleep a blissful experience sans the background scores with snores- start following these changes and sleep peacefully!

What Is Obstructive Sleep Apnea in Adults?

Dr. Rajesh Swarnakar, Pulmonologist
Obstructive sleep apnea (OSA) is a common problem that affects a person’s breathing during sleep. A person with OSA has times during sleep in which air cannot flow normally into the lungs.  The block in airflow (obstruction) is usually caused by the collapse of the soft tissues in the back of the throat (upper airway) and tongue during sleep.Apnea means not breathing. In OSA, you may stop breathing for short periods of time. Even when you are trying to breathe, may be little or no airflow into the lungs. These pause in airflow (obstructive apneas) can occur off and on during sleep, and cause you to wake up from a sound sleep. Frequent apneas can cause many problems. With time, if not treated, serious health problems may develop.OSA is more common in men, women after menopause and people who are over the age of 65. OSA can also occur in children, there are several groups of people who are particularly at risk for developing OSA people who are overweight are more likely to develop sleep apnea.  OSA can occur in people who have large tonsils people of normal size and in people with certain type of jaw problems. People with these jaw problems have difficulty keeping the back of their throat open. Some of this condition is called micrognathia (a small jaw) and retrognathia (a pulled back jaw.)What are the symptoms ofobstructive sleep apnea?There are many clues that tell your provider that you may have OSA. You may not be aware that you have OSA, but these symptoms may be more obvious to a spouse, other family member, or close friend.Common symptoms you may have during sleep:§  Snoring that is usually loud and bothers others people trying to sleep near you.  Snoring can come and to through the night.§  Gasping or choking sound§  Breathing pauses observed by someone watching you sleep.§  Sudden or jerky body movements§  Frequent awakening from sleep Common symptoms you may have while awake:§  Wakeup feeling like you have not had enough sleep, even after sleeping many hours§  Morning headache§  Dry or sore throat in the morning from breathing through your mouth during sleep§  Sleepiness during the day§  Fatigue or tiredness through the day§  Personality charges, such as mood swings and difficulty getting along with others§  Problems with poor memory or usability to concentrateCan OSA be dangerous?Lack of sleep can cause you to fall asleep while driving andresult in car accidents. Periods of stopping breathing can, with time, cause high blood pressure (hypertension,)heart disease, stroke or early death. How do I know I Have OSA?The signs of OSA described above should make you seek help for an evaluation.  Discuss your problems with you health care provider.  They can sort through some of the problems you are having and determine whether you should be evaluated further at a sleep center.OSA is diagnosed by a sleep study (or polysomnogram). Asleep study is generally done at a sleep center where you will be scheduled to sleep overnight. During this time, your breathing, heart rate, sleep state andoxygen levels will be monitored.How is obstructive sleep apnea treated?Sleep apnea can be effectively treated, and there are a numberof ways to do so.  The type of treatment recommended will depend on the reason for and severity of the sleep apnea.  If your OSA is from being overweight, weightloss may cause the apnea to go away completely. You can avoid alcohol for at least 4 hours before going to bed.  If you sleep on your back, you can use apillow or some other strategy to force yourself to sleep on your side.  Some people sew a tennis ball into their pajama bottoms to remind them not to turn on their back.Continuous Positive Airway Pressure (CPAP) is a common device ordered to treat most conditions of OSA. CPAP is delivered by a compressor that blows air (with or without oxygen) into a mask that is worn snugly over the nose and or mouth during sleep. The flow of air acts like a splint to keep the upper airway from collapsing.  This helps prevent obstruction and the apnea from occurring.  The air pressure is adjusted to a setting that best controls the apnea.  Often a person will also notice much less snoring when wearing CPAP.There are device and surgeries which can be done to treat OSA. The type of device or surgery will depend on what has cause the apnea.  Some appliances or devices (called oral devices) that are airway open. Most oral devices work by either bringing the jaw forward or keeping the tongue from blocking the throat.  Orals appliances are most likely to help aperson who has mold sleep apnea and who is not overweight.  These devices are usually custom-made and fitted under the supervision of specialized dentist or oral surgeon who works with these problems.Surgery may be recommended in some cases.  When the tonsils or adenoids are causing the throat to be blocked, a tonsillectomy may be recommended.  Surgery may also be helpful for patients with jaw problems.  Other surgeries for OSA either clear out the tissue from the back of the throat or reposition the tongue forward.  These surgeries are not, however, as effective as CPAP to control your OSA and are usually reserved for patients who fail CPAP.

Snoring in Babies

Dr. Rahul Varma, Pediatrician
As uncommon and abnormal as it may seem, snoring in babies is not always a red flag for your baby's health. Many babies produce noises like whiffing, snuffing and snoring while sleeping. If your baby snores rarely or occasionally, then it's not a cause of concern. But if it has become a chronic habit of your little angel to snore, then consulting your Pediatrician is always advisable. But before you start panicking, let's understand the causes of snoring in babies. Causes of Snoring in Babies Cold and flu infections: This is the most common cause of snoring in babies. As your baby's airways are very small and narrow when they are few months old, mucous secretions during a cold or flu infection easily block her nose and throat. As a result, your baby may snore while she is suffering from cold or throat infections.Allergies: Your baby may be allergic to down filling in the mattress or pillows or allergic to pet hairs if you have a dog or cat. This may obstruct the airways of your baby while she sleeps and become the cause of snoring.Enlarged tonsils or adenoids: Adenoids are lymph nodes at the junction of nose and throat which may enlarge due to various infections. Similarly, tonsils are lumpy lymph tissues located at the back of throat, which can also enlarge due to repetitive infections. Although the rate in newborn babies, with time these can contribute to obstruction in breathing which can in turn cause snoring. Deviated Nasal Septum: Nasal septum is the bone that separates both the nostrils and in case of a deviated septum, this bone may be structurally misaligned obstructing one of the nostrils. This could be a cause of chronic snoring in your baby. Laryngomalacia: In very young babies, the cartilage that keeps the nasal airways open may remain underdeveloped for some time after birth. As a result, your newborn may snore frequently until this cartilage develops properly. Throat abnormalities: Cystic formations in the throat or abnormal palate movement can also cause snoring in babies. Sleep Apnea: This is a condition wherein your baby experiences obstruction in breathing for several seconds, causing lack of oxygen and acute breathlessness. This may happen multiple times during sleep and can cause loud snoring in your baby. How to correct snoring in your baby? Once you have identified the cause of snoring in your baby, in consultation with her pediatrician, you can start with the corrective measures to alleviate your baby's snoring. You can take the following steps to correct snoring:If your baby is suffering from cold, flu or allergies; use a humidifier in your baby's room and put saline nasal drops in your baby's nose to help her breathe better while sleeping. Also remove any allergens or allergy-causing agents from your baby's room to avoid any breathing obstructions.Change your baby's position or put a pillow under her head when she's asleep to help keep her airways open. If your baby is suffering from sleep apnea, enlarged adenoids and tonsils may be responsible. You can either reduce this enlargement with medicines or can even get them surgically removed once your baby is a little older.Throat abnormalities and deviated nasal septum can only be corrected surgically and you should consult your Pediatrician/ ENT specialist for complete corrective action. Thus, if your little one snores, the next time she dozes off, rest assured that it's nothing to worry about. With proper care and as she grows, this problem can be easily resolved.