Health Shape Up
for Your Beauty Sleep
by Neeta Lal
Meeta Vohra's
loud snoring had become the butt of family jokes lately. Her kids would
imitate the 'funny sounds' mom made while sleeping and then double up
with laughter. Initially, even Vohra, 43, would join in the fun, but
gradually - when tiredness and grogginess started interfering with the
schoolteacher's daily routine - the joke stopped being funny. And Vohra
decided to see her physician about it.
The physician's diagnosis was disconcerting - Vohra
was suffering from obstructive sleep apnea (OSA).
Elaborates Dr K.K. Handa, ENT specialist at the All
India Institute of Medical Sciences (AIIMS), New
Delhi, "It is a common sleeping disorder in which one
has one or more pauses in breathing or has shallow
breathing during sleep. The pauses can last from a few
seconds to a few minutes. They often occur five to 30
times or more in an hour. Typically, normal breathing
then starts again, sometimes with a loud snort or
sputtering sound." This occurs due to an obstruction
or narrowing of the airway in the nose, mouth or
throat and can lead to an increased risk of diabetes,
high blood pressure, heart attack, stroke and even
obesity.
According to the International Diabetes Foundation
(IDF), which had convened a summit of renowned
specialists in Sydney, Australia, last year, sleep
apnea - earlier thought to be largely a disease of men
- is increasingly afflicting women. Though no official
figures were released, the consensus among the
participants was that apnea could severely impact
human health climaxing in Type 2 diabetes along with a
host of other ailments.
This is reiterated by doctors back home who say that
more and more Indian women, especially in the 30 to 60
years age bracket, are succumbing to sleep apnea. "I'd
say about 10 per cent of Indians would be suffering
from sleep apnea, half of which would be women,"
elaborates Dr Ajay Rastogi, Senior Consultant, Fortis
Hospital, New Delhi, who has been counselling scores
of patients with sleep disorders lately. Even young
girls and boys, says the doctor, are being diagnosed.
The condition is found frequently in people who tend
to snore or those who are overweight.
Unfortunately, sleep apnea often goes undiagnosed, as
it is difficult for doctors to pin down the condition
during routine investigation. Moreover, there are no
prescribed tests for the condition. Even people who
suffer from sleep apnea don't know they have it
because it only occurs during sleep. A family member
is usually the first to notice the signs of the
chronic condition. "I come across many patients who
are referred to us by other doctors through a
two-three tier process, as physicians often find it
tough to detect sleep apnea," says Dr A.S. Srivastav,
a Delhi-based ENT specialist.
Dr Rastogi though has a pointer that family members
can keep in mind. "If the breathing stops for more
than 10 seconds around five times in an hour, it is a
case of OSA."
For women, especially, sleep apnea can have disastrous
consequences. According to Dr Michael S. Nolledo,
M.D., University of Medicine and Dentistry of New
Jersey at Princeton, USA, sleep apnea raises a woman's
risk for gestational diabetes by twofold and
pregnancy-induced hypertension four times. Such women
may, however, need treatment only during pregnancy, he
feels, as apnea during pregnancy usually crops up
because of nasal congestion or rhinitis induced by
hormonal changes or weight gain.
Studies reveal that undiagnosed sleep apnea may also
affect women's sexual function by reducing sexual
desire, sensation and lubrication, negatively
impacting their relationship with their partner. In a
study published in the 'Journal of Sexual Medicine' in
2005, researchers evaluated the sexual function of 25
pre- menopausal married women - average age being 48
years - diagnosed with OSA at a university sleep
centre in Turkey. The results showed that as the
severity of sleep apnea increased, sexual function
scores decreased among the women.
Snoring among children does not necessarily signify
sleep apnea but could be due to enlarged tonsils or
adenoids. However, in children, sleep apnea needs to
be cured as it leads to mental distress, low school
performance, irritability and hyperactivity.
Doctors say that OSA becomes common with advancing
age. At least one out of 10 people over the age of 65
has this condition and women are particularly at risk
after menopause. Sleep apnea is also genetic. People
who have small airways in their noses, throats, or
mouths also are more likely to develop the condition.
Currently, there are no medicines or drugs to treat
sleep apnea. For mild sleep apnea, doctors recommend
lifestyle modifications like avoiding alcohol and
shunning sleeping pills, which make it harder for the
throat to stay open while one sleeps. Knocking off
excess weight also goes a long way in fobbing off this
ailment.
In acute cases, however, patients have to wear
'Continuous Positive Airway Pressure' (CPAP) masks
over the nose during sleep. This mask delivers air
into the airways creating enough pressure during
inhalation to keep the airways open. Some people may
also benefit from surgery, which is done to widen
breathing passages. It usually involves removing,
shrinking, or stiffening excess tissue in the mouth
and throat or resetting the lower jaw.
In some countries, sleep apnea patients are often
referred to sleep clinics, which can treat such
conditions better. In France, for instance, doctors
have been studying sleep disorders seriously since the
Sixties. The United States and Australia, too, are
very sleep-disorder savvy. However, India woke up to
its first sleep clinic at AIIMS as late as 1985. Now,
of course, more sleep centres have been set up in
cities such as Bangalore, Kolkata, Mumbai, Chennai and
Coimbatore.
"The idea," sums up Dr Srivastav, "should be to create
public awareness about this seemingly innocuous
ailment, which can have life-threatening consequences.
The more informed people get about this ailment, the
better it will be treated and it's damage contained."
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Meeta Vohra's
loud snoring had become the butt of family jokes lately. Her kids would
imitate the 'funny sounds' mom made while sleeping and then double up
with laughter. Initially, even Vohra, 43, would join in the fun, but
gradually - when tiredness and grogginess started interfering with the
schoolteacher's daily routine - the joke stopped being funny. And Vohra
decided to see her physician about it.