Take snoring seriously

SNORING is considered irritating and many people do not know that it is a sign of Obstructive Sleep Apnea (OSA), a common medical disorder that is potentially life-threatening and has far-ranging implications.

People who have OSA stop breathing repeatedly during sleep because their upper airway collapses. This causes them to experience constant sleep disruption, snoring loudly or even gasping or choking during sleep due to apneas (pauses in breathing).

The upper airway collapse may be due to decreased muscle activity, increased tissue around the airway or structural features that lead to a narrowed airway.

As a result, air is prevented from getting into the lungs, carbon dioxide levels in the blood rise and sleep is disrupted. These pauses in breathing can happen as many as 30 times or more an hour, leading to chronic poor quality sleep.

Do snorers realise that they may face this health problem?
Unfortunately, there are still many people around the world who view snoring as normal and not a problem. Sometimes, it is believed to indicate sound sleep and snorers are perceived as people with robust health. I do my best to change these erroneous perceptions by sharing information on sleep disorders with healthcare professionals around the world.

What is the prevalence of OSA among Malaysians?
Research indicates that on average, OSA affects 24 per cent of Malaysian males and nine per cent of Malaysian females. Alarmingly, 80 per cent of these sufferers do not know they have OSA and leave the condition untreated. Overall, it is estimated that as many as three million Malaysians suffer from OSA, mainly undiagnosed and untreated.

How should the healthcare system address this situation?
There is a huge need to train physicians and nurses in this country to diagnose sleep apnea and to treat the disorder. Currently, there are only 10 specialised sleep physicians in the country, plus a few dozens doctors who treat sleep disorders on a part-time basis. In general, medical students and other healthcare professionals are not sufficiently educated on sleep disorders such as OSA and doctors rarely ask patients if they are getting quality sleep, thus the chronic problem persists.

What are the effects of OSA on those who suffer from the condition?
Due to lack of quality sleep, people suffering from OSA typically experience excessive daytime sleepiness. They tend to fall asleep during routine activities, have poor concentration, suffer frequent headaches and are often irritable. The long term impact is serious and wide-ranging. Without good sleep, the human body is unable to grow, recuperate, heal and regenerate.

Brain function, the metabolic rate, energy balance, the immune system are all adversely affected.
Untreated OSA may put sufferers at risk of a number of life-threatening conditions, including cardiovascular disease, stroke, high blood pressure, abnormal heart rhythms, Type 2 diabetes, depression, learning impairment and memory loss. In children, brain development and learning ability are compromised.

Are there risk factors for OSA?
Although OSA is more common in people who are obese or have a large neck, or crowding of the upper airway, it can occur in men, women and children of all ages and sizes. Most people who have OSA do not realise that they suffer from the condition. It is often the bed partner or family member, who notices the signs of the condition.

For children who have the condition, the majority of them develop the disorder when they are 6 to 8 years old. While more men than women have OSA overall, menopause causes the percentage of women with OSA to rise.

Heavy smokers and drinkers, and people above 45 years, are also more likely to develop the condition. Genetics too is a factor. Nevertheless, those who are young, thin and healthy should not disregard possible signs of OSA as they too can also suffer from the disorder.

How is OSA diagnosed?
The sleep specialist will determine the most suitable screening or diagnostic test. For a definitive diagnosis, an overnight sleep study is carried out, usually at a sleep centre. The safe and painless study monitors your sleep, respiratory parameters and heart activity.

How is OSA treated?
Many ways are used, from simple measures such as weight loss, avoiding alcohol in the evening and sleeping on your side to invasive and non-invasive medical treatment such as upper airway surgery, dental devices and the commonly used and most effective — continuous positive airway pressure (CPAP).
This method provides a continuous non-invasive gentle flow of air through your nose using a CPAP mask to prevent upper airway collapse and allows you to breathe more easily while you sleep.

EXTRA RESOURCES

PHILIPS has made several Internet-based tools available to share knowledge on sleep medicine such as the Sleep Power Quotient quiz to grade a person’s quality of sleep.
Upon completion of the Sleep Power Quotient quiz, any individuals with results that point to poor sleep habits will then be invited to take an online risk assessment test to determine their risk level for OSA.
Those at high risk for OSA will be directed to follow up with their healthcare provider.


Read more: Take snoring seriously - Health - New Straits Times