Times of India
10 January 2011
By Sayoni.Sinha

Don’t dismiss your snoring and disturbed sleep as mere annoyance. Get yourself checked for sleep apnea
Pradeep Gogari hadn’t had a good night’s rest in a long time. To add to his difficulty in sleeping and breathing properly at night, he would often wake up with a sudden start and drift back to sleep much later. Gogari ignored his disturbed sleep and often took quick–fix nasal clearance medication instead. Without proper rest, he woke up on most mornings feeling lethargic and zapped of energy.

At 155 kgs, this 42–year–old was morbidly obese with high blood pressure in the range of 110–170. When he came to Dr Shashank Shah, Laparoscopic and Bariatric Surgeon at Dr LH Hiranandani Hospital he was diagnosed suffering with sleep apnea. "I knew I snored, but I didn’t know that I had a medical disorder. Twelve years ago, I had a car accident which left me in coma for three months and bed ridden for another six months. Left with nothing to do, I took refuge in food. After that, I never got back to normal weight or a good nights’ sleep," says Gogari.

When Sleep Eludes
Sleep apnea is a common disorder in which the breathing becomes shallow or pauses for a few seconds while sleeping. "This can happen for more 30 times an hour, resulting in poor sleep quality that makes you tired during the day. It’s also one of the leading causes of excessive daytime sleepiness. Most people who have sleep apnea don’t know they have it since it happens only while they sleep," says Dr Shah.

What Gogari didn’t realise was the role his obesity was playing in his disturbed sleep patterns. He started with snoring few years ago, which was neglected as a common annoyance. This soon progressed into episodes of disturbed sleep due to inadequate supply of oxygen to his brain for a short span of time, a few times each hour. "My wife used to complain that my loud snoring didn’t let her sleep well at night.

So I self–medicated myself and bought nasal drops, thinking that my snoring was due to a blocked nose," he says. The most common type of sleep apnea is known as obstructive sleep apnea. This means that the airway collapses or is blocked during sleep.

The blockage may cause shallow breathing or pauses while breathing. When you do try to breathe, any air that squeezes past the blockage then causes loud snoring. Obstructive sleep apnea is a serious health problem since it is also responsible for the accumulation of carbon dioxide in the blood.

This is toxic for the heart as well as the brain. "This is also called daytime somnolence or obstructive airway disease and can also prove to be fatal if not treated in time," adds Dr Shah. Sleep apnea often goes undiagnosed as doctors usually can’t detect the condition during routine office visits.

Obesity The Culprit?
Several studies show untreated sleep apnea is a risk factor for high blood pressure. Studies also suggest an association between untreated sleep apnea and a stroke, as well as other cardiovascular diseases. Additional consequences of untreated sleep apnea include heartburn, nocturia (the need to use the bathroom frequently at night), depression and weight gain.

According to Dr Shah, 80 per cent of the patients suffering from sleep apnea are obese and have a Basal Metabolic Index (BMI) of more than 33 and the additional fat around the neck may make the airway narrower, making obstructions more likely to occur. "The most effective treatment will be to bring the BMI down to normal and lose weight." Three months ago, Gogari underwent bariatric surgery and a complete lifestyle change to bring his weight down to 100 kgs. "Now, I am conscious about what I eat and walk twice a day. I sleep like a baby now," concludes Gogari.

Watch Out For

• Do you snore at night? (ask your parents or your partner)
• Do you get sound sleep at night?
• Do you feel sleepy and lethargic during the day? If your answer to most of these questions is yes, then…
• Avoid heavy calorie meal at night
• Avoid alcohol, tea or coffee at night
• Body should be properly hydrated
• See a doctor immediately