There exist many Sleep disorders, out of which the most common are snoring and insomnia. Almost every individual has experienced these disorders at least once in their lifetime. However, the actual cause of problematic insomnia is not clear. Same is the case with snoring, as minimal data on snoring is available. According to a local research which took place in 1999, 24% of local adults are known to snore, and 15% suffer through obstructive sleep apnoea. Sleep apnoea refers to a condition in which snoring is not the only problem, but there also is a blockage in the air passage while a person is asleep, which leads to poor sleep quality and low oxygen levels.
The leading cause of insomnia is related to psychological and mental well being, with depression, stress, and anxiety. However, sometimes the cause can be due to physical pain. Physical discomfort is a result of some medical conditions, diseases like an overactive thyroid gland or medications like decongestants that excite the body. Other than that, bad sleeping habits like variation in sleep timings or indulging in stimulating activities like playing computer games may also lead to insomnia.The first step towards improving insomnia is to figure out the cause. The doctor analyzes a detailed history of the daily activities and sleep habits. While consultation, you are required to share all these details with your doctor. The easiest way to make this happen is by keeping a diary which includes the list of the daily activities you’re a part of as well as your sleep pattern over a few weeks. Tests aren’t so necessary in this situation, however, if there are any symptoms of a disease like a thyroid, then a blood test might be ordered by the doctor. Other reasons that can keep a person awake or wake them up from sleep like frequent urination, blocked nose, chronic pain, etc. can require a medical opinion from other specialists. Furthermore, if sleep disorders are suspected, then a sleep study becomes necessary.
- Adapting good and healthy sleep habits is the most crucial step in treating insomnia. These are:
- Preserving a sleep pattern which is regular.
- Not indulging in stimulating activities right before you sleep.
- Using the bed only for sleeping and not for activities such a reading or watching TV etc.
- Stay away from stimulants like decongestant medications or caffeine.
- Exercising should preferably be done during the morning hours.
- If unable to fall asleep, one should not lie in bed for a long time.
- Minimizing stressors and relaxation techniques are some behavioral methods which are usually helpful.
Sleeping pills are the medicines used to cure insomnia. Other medications like anti-histamines are known to induce sleepiness. These should not be utilized in a long term as there exists a potential for addiction. Therefore, these are helpful in the beginning to break the cycle of insomnia and establish a good sleep pattern.
Snoring and obstructive sleep apnoea (OSA)
Snoring becomes a far more severe problem when airway blocks up while sleeping. It’s known as obstructive sleep apnoea (OSA). The airway blockage leads to a drop in the oxygen level and bad sleep quality. As per research, there has been a link found between OSA and cardiovascular diseases like high blood pressure, heart disease, and stroke. People suffering from severe OSA, have a risk of heart attack and stroke which is three times greater than the standard risk. As per a study in Singapore, over 65% of heart attack patients were found to be suffering from undiagnosed moderate to severe OSA. In the case of children, OSA may lead to weak school performance and complication in learning and concentrate. It is also known to increase the risk of developing diabetes and cardiovascular disease in the long run.
Alerting signs of obstructive sleep apnoea
- One needs to consult a sleep physician or an ear-nose-throat (ENT) surgeon or sleep physician if they have the following symptoms accompanied with snoring:
- You stop breathing during sleep, as discovered by your sleeping partner.
- You feel excessively sleepy during the daytime.
- You’re out of breath when you wake up in the middle of the night, and you also experience a choking feeling.
- You often suffer headaches in the morning hour.
- You become irritable or have difficulty in concentrating along with poor memory.
- There’s an urge to urinate frequently or if children are experiencing bedwetting.
Doctor’s conduct a sleep study to determine the presence of OSA. This study is either performed at your home or in the hospital. Another procedure which required is known as outpatient endoscopy, in which the doctor uses a thin and long tube to analyze an internal organ of your body. The tube enables the doctor to look at the points of obstruction. Obstruction usually occurs in the back of the tongue, nose or at the soft palate of the tongue
Nose blockage is caused by a crooked nasal septum or soft tissue swelling. At the second level, the soft palate and tonsils are known to cause obstruction. Whereas, the back of the tongue is known to obstruct at the lowest level. The purpose of a sleep study is to assess the extremity of your OSA. According to the findings on outpatient endoscopy, the treatment is crucial. In the case of children, the treatment for OSA takes place with the removal of the adenoids and tonsils.
Treatment of OSA
For mild OSA, simple procedures like radio-frequency are used to open up the airway, and to stiffen up the soft palate or reduce soft tissue in the nose. On the other hand, oral appliances are used to retain the tongue or bring forward the jaw.
In moderate to severe OSA, a continuous positive airway pressure device is known to give the best results. The device consists of a pump that pressurizes air via a mask strapped to your face when sleeping. However, most patients are not willing to use it. In that case, the next best option is surgery.
The inspiration for this article has been taken from Health Plus Section, a source of credible health information by Mount Elizabeth Hospitals, Singapore.