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Sleep Apnea & Snoring

Services for Sleep Management Center

Sleep Apnea & Snoring

Sleep APnea and Snoring

Sleep Apnea is a sleep disorder in which breathing repeatedly stops and starts. We may have sleep apnea if we snore loudly and feel tired even after a full night's sleep.


Complications may include:

  • Cardiovascular problems : The more severe your sleep apnea, the greater the risk of high blood pressure. If there's underlying heart disease, these multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from a cardiac event. Obstructive sleep apnea also increases the risk of stroke, regardless of whether you have high blood pressure.
  • Daytime fatigue : Severe daytime drowsiness, fatigue and irritability is experienced. Concentration difficulty. Falling asleep at work, while watching TV or even when driving. Irritability, moodiness and depression`feelings of depression.
  • Daytime fatigue : Severe daytime drowsiness, fatigue and irritability is experienced. Concentration difficulty. Falling asleep at work, while watching TV or even when driving. Irritability, moodiness and depression`feelings of depression.
  • Urinary and sexual function : A need to get up for urination frequently at night, and impotence.
  • Gastrointestinal problems : Gastroesophageal reflux disease (GERD) may be more common in people with sleep apnea.

There are three types of Sleep apnea :

  • Obstructive sleep apnea : This type occurs when throat muscles relax.
  • Central sleep apnea : This type occurs when your brain doesn't send proper signals to the muscles that control breathing.
  • Complex sleep apnea : In this type both the above mechanism play a role.

Obstructive Sleep Apnea

Obstructive sleep apnea occurs when the muscles in the back of throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate known as uvula, the tonsils and the tongue. The muscles relax, the airway narrows or closes as we breathe in, and breathing stops for some time. This may lower the level of oxygen in blood. Our brain senses this inability to breathe and briefly rouses us from sleep so that we can reopen airway. This awakening is usually so brief that we don't remember it. We can awaken with a transient shortness of breath that corrects itself quickly, within one or two deep breaths, although it is rare. We may make a snorting, choking or gasping sound. This pattern can repeat itself 10 to 40 times or more in an hour, during the whole night. These disturbances decrease the levels of necessary deep sleep, restful phases of sleep. Because of this there is sleepy feeling during day time. People may not be aware that their sleep is interrupted. In fact, many people with this type of sleep apnea think they sleep well during night.

Central Sleep Apnea

Central Sleep Apnea occurs when the brain fails to transmit signals to breathing muscles. Person may awaken with shortness of breath or have a difficult time staying asleep. Like obstructive sleep apnea, snoring and daytime sleepiness can occur. The most common cause of central sleep apnea is heart disease, and stroke. People with central sleep apnea may be more likely to remember awakening than people with obstructive sleep apnea are.

complex Sleep Apnea

complex sleep apnea patients have upper airway obstruction just like those with obstructive sleep apnea, but they also have a problem with the rhythm of breathing and occasional lapses of breathing effort.

Following factors may be considered as risk factors for sleep apnea:

  • Excess Weight
  • Neck circumference : A neck circumference greater than 17.5 inches is associated with an increased risk of obstructive sleep apnea.
  • High blood pressure : People with hypertension may suffer from sleep apnea.
  • A narrowed airway : This may be a congenital defect.
  • Being male : Sleep apnea is more common in male than female.
  • Being older : Sleep apnea is more common in elderly age group.
  • Family history : Positive family history is an additional risk factor.
  • Heart disorders and stroke or brain tumour : These are related to central sleep apnea.

What can be done?

  • An overnight sleep study can be performed to diagnose the problem.
  • PSG (polysomnography) can tell us the type of sleep disorder as well as the degree of problem.
  • Apneagraph - This is the only investigation that determines the site of obstruction. Less than 10 units of its kind exist in the country.


  • CPAP : The gold standard
  • Surgery : Upper airway surgery can be considered in those cases who cannot tolerate CPAP machines or for non-tongue base hyperplasia.

CPAP machine :

CPAP machine is a device that generates a strong air flow which is delivered through a mask. This pushes away the soft tissues of the throat, and when correctly administered, can be an immediate treatment for both snoring and sleep apnea. However, many patients do not wish to wear a mask for life.


Surgery is contemplated for patients with airway obstruction who cannot or will not wear a CPAP device. It is only to be done when the cause of the obstruction can be defined precisely.

Surgery is directed to improving the airway. In children, it is performed by removing the tonsils and adenoids. This usually creates adequate airway to treat the symptoms completely. Bedwetting is common in children with large adenoids and tonsils causing obstruction and apnea. This symptom is effectively treated by removing the obstruction caused by large tonsils and adenoids.

Surgery can be performed at various levels in the airway :
  • Level 1 : If the obstruction is due to a blocked nose due to allergies, a deviated nasal septum (the partition between the 2 nostrils) or polyps in the nose, the nasal airway surgery would give excellent results.
  • Level 2 : The level of the soft palate and tonsils: In adults, in addition to removing the tonsils, the soft palate (which is the structure which vibrates, creating the noise of snoring) is tightened. This is done most effectively with a COBLATOR, a modern device which allows bloodless surgery.
  • Level 3 : The base of the tongue: Sometimes, the base of the tongue is also reduced simultaneously with the coblator.