​Obstructive Sleep Apnea ​

A common disorder, sleep apnea is characterized by disturbed or interrupted breathing while sleeping. The​​ pauses in breathing could be as short as ten seconds to a few minutes. Typically, the breathing may pause twenty to thirty times in an hour, making sleep apnea a serious disorder. Sleep apnea is a chronic disorder that leads to poor quality of sleep, often leaving you tired the next day. 

There are two types of sleep apnea:

  • Obstructive sleep apnea – airflow into the lu​​ngs through the mouth and nose is blocked, interrupting breathing. Attempts to breathe normally results in a snorting or choking sound. 

  • Central sleep apnea – occurs due to inability of the brain to send signals to muscles that control breathing. There is no airway obstruction in central sleep apnea.

Obstructive sleep apnea is more common than central sleep apnea. It is caused due to excessive relaxation of muscles at the back of your throat, which results in blocking of the airways leading to y​our lungs. In babies and small children, obstructive sleep apnea may be caused due to enlarged tonsils. 

As your breathing is interrupted, you may wake up for a short while with a choking or loud snoring sound to restore your breathing, but never realize that your sleep was interrupted as it is usually very brief. This can happen anywhere between five to thirty times in an hour, causing much discomfort for people who sleep with you.

The constant interruptions in your sleep prevent you from going into deep, restful sleep, making you tired when you finally wake up. It also causes daytime sleepiness, even though you may think you rested well at night. Besides daytime sleepiness and fatigue, interrupted breathing which causes lower oxygen l​evels can also put a strain on your cardiovascular system, making you more susceptible to cardiovascular disorders. 

People with sleep apnea also have to be cautious with the use of certain medications and general anaesthesia, as these can worsen airway obstruction. Chances of post-surgery complications are also high for people suffering from obstructive sleep apnea, and that’s why you must inform your doctor about your obstructive sleep apnea before any surgical procedure. 

Overweight people, smokers, those with a family history of obstructive sleep apnea, alcohol consumers, diabetics, and people with high blood pressure disorder are at greater risk for developing sleep apnea. Having a thick neck, which can obstruct the airways or having chronic nasal congestion also put you at a higher risk for obstructive sleep apnea.​

Because you never realize there have been interruptions in breathing while you were sleeping, sleep apnea can be difficult to identify on your own. People who sleep with you can give a better idea of any particular symptoms and characteristics of your sleep, such as waking up suddenly quite a few times with a loud snort or very loud snoring while you sleep. You partner will also be able to tell if they notice any sudden pauses in breathing. 

Signs and symptoms which you may be able to notice include:

  • Feeling tired and sleepy during the day

  • Waking up with a dry mouth or sore throat

  • Inability to concentrate during the day

  • Morning headaches

  • Mood swings 

  • High blood pressure

  • Falling asleep easily without meaning to

  • Memory problems

  • Frequent urination at night

You must observe these signs in your child or ask your partner to observe you during sleep if you suspect you may have sleep apnea. Immediate medical attention must be sought for patients of sleep apnea to prevent further complications arising out of this disorder. ​​


Though snoring may seem as a harmless symptom, heavy, intermittent snoring (that starts suddenly and then pauses in between) is a sign of sleep apnea. The symptoms are worse when you are sleeping on your back. If your partner notices these symptoms while you sleep, you should consult an otolaryngologist, ENT (Eye-Nose-Throat) specialist, working with the Eye and ENT service line at The Aga Khan University Hospital.

If you yourself notice the symptoms mentioned above, such as daytime fatigue and sleepiness, you should not wait to get a professional medical opinion.​


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Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started. ​
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Your medical history, including your partner's account of your sleeping habits, will help form an initial diagnosis of your condition. Subsequently, your doctor will conduct a physical examination, which will include a detailed check-up of the back of your throat and mouth to see if there is any extra tissue that could be obstructing the airways.

You may also be asked to undergo a sleep test called PSG (polysomnogram). A trained sleep specialist will monitor your sleep in this test, checking for all bodily functions such as oxygen levels, breathing patterns, eye movement, heart rate, airflow and the brain's activity while you sleep. This will help identify the number of times your breathing was interrupted while you slept. You may undergo this test for the full night or for one half of the night on one day and the next half on another. Your doctor may also recommend an at-home version of polysomnography to diagnose obstructive sleep apnea while you are on the go.

A test to check your blood oxygen levels will also be conducted to observe any drop in oxygen levels while you sleep. ​


Depending on the diagnosis, the doctor will recommend a treatment plan for your sleep apnea. Certain lifestyle changes will help manage symptoms of milder sleep apnea, such as:

  • Losing weight if you are overweight

  • Exercising regularly

  • Quitting smoking and cutting down on alcohol consumption

  • Not sleeping on your back

If the above measures do not help improve your symptoms, the following may be recommended:

  • Mouth pieces designed to keep your throat and airway open

  • Medications to help reduce sleepiness during the day

  • Air pressure treatment with the help of a special machine with a piece fitted to your nose and mouth to help deliver air pressure

  • Surgery for removal or fixing any anatomical irregularity in the throat and mouth causing obstructive sleep apnea (possible risks of surgery must be discussed in detail with your doctor)​


The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hosp​​ital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the 'Important Numbers' section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments' costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the 'Important Numbers' section on the website homepage.​


Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.


 


 


 

​​​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.