WORLD SLEEP DAY 2021 Regular Sleep, Healthy Future

Dr S Pahel Meitei
Contd from last Saturday
These episodes are associated with recurrent oxyhemoglobin desaturations and arousals from sleep. OSA associated with excessive daytime sleepiness is commonly called obstructive sleep apnea syndrome—also referred to as obstructive sleep apnea-hypopnea syndrome. Apart from other anatomical and endocrine causes, obesity is an important modifiable risk factor for OSA. A 10% increase in body weight is associated with 32% increase in Apnea-Hypopnea Index (AHI: index for diagnosis and grading severity of OSA). A 10% reduce in body weight is associated with 26% reduction in AHI. Weight related changes in AHI are more marked in male then female.
OSA is an independent risk factor for hypertension and other cardiovascular ailments. Untreated sleep apnea may lead to heart diseases, stroke, and vascular dementia. In children, sleep apnea may be the underlying cause of neuropsychological disturbances. Pediatric sleep apnea is typically associated with adeno-tonsillar hypertrophy.
Nocturnal symptoms may include: Snoring, usually loud, witnessed apneas, gasping and choking sensations (that arouse the patient from sleep), nocturia, insomnia (restless sleep), etc. Daytime symptoms may include: Nonrestorative sleep, morning headache, dry or sore throat, excessive daytime sleepiness, daytime fatigue/tiredness, cognitive deficits; memory and intellectual impairment, decreased vigilance, personality and mood changes, including depression and anxiety, sexual dysfunction, including impotence and decreased libido, gastroesophageal reflux, hypertension, etc.
Both adults and children should be formally investigated in sleep centers if sleep apnea is suspected, because both adult and pediatric sleep apnea is treatable and correctable; a correct and precise diagnosis is always required.
Sleep apnea is diagnosed with sleep study (polysomnography: PSG) in the sleep laboratory. There are various levels of sleep study. Some can be done at home with portable machines.
Treatment with non-invasive positive airway (continuous positive airway pressure, or CPAP) ventilation is generally successful. For mild forms of sleep apnea, the application of oral devices can be beneficial. Surgery to remove excessive tissues in the oropharynx may be considered for individuals who cannot tolerate non-invasive equipment or who have obvious obstruction to airflow in the oropharynx by redundant tissue growth or large tonsils. There is proof that successful correction of sleep apnea with non-invasive positive airway pressure ventilation lowers mean blood pressure and may reduce the risk of myocardial infarction and stroke. Excessive daytime somnolence generally improves with successful treatment of sleep apnea.
Restless legs syndrome (RLS) is a sleep disorder that causes an intense, often irresistible urge to move the legs. This sensation is brought on by resting such as lying down in bed, sitting for prolonged periods such as while driving or at a theatre. RLS typically occurs in the evening, making it difficult to fall asleep and stay asleep. It can be associated with problems with daytime sleepiness, irritability and concentration. Often, people with RLS want to walk around and shake their legs to help relieve the uncomfortable sensation. It is a treatable condition that responds well to medications.

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