Snore No More – Dark Side of Sleep Apnea

There is no bigger honor and privilege than to treat a child who is in distress. I am a Pediatric ENT who specializes in airway and snoring surgery. Whose primary goal of treatment is to give people better breathing. Airway surgery requires very complex training and is high-risk surgery. It deals with problems of the windpipe (trachea), voice box (larynx), and throat. 20 years back, the success rate for Airway narrowing problems in India was abysmally low. The chances of training for such complex surgeries in India were minimal,and I decided to do a visiting fellowship at the world’s best airway center, Cincinnati Children’s Hospital, USA.

This training helped me to introduce several airway surgeries, like balloon laryngoplasty, alar grafting, and slide tracheoplasty, for the first time in the country. I have worked for underprivileged sections in India and abroad to perform complex airway surgeries free of cost and sometimes even pay from my pocket. These patients have minimal access to health care and cannot afford treatment in private surgeries. This mission involves training junior surgeons for complex field and develop pediatric ENT in India at par with countries like the USA. Snoring is universal; hence its mostly perceived as a sleeping nuisance rather than a health hazard. People are not aware that snoring people can manifest sleep apnea, A.K.A obstructive sleep apnea, which means that during sleep, there is a pause in breathing and a decrease in oxygen levels.

This can cause fatigue, memory loss, irritability, headache, and a tendency to doze off while driving or operating machinery. In personal life, relationships can become strained leading to depression and anxiety issues. But the worst damage is done in the long term, increasing the risk of blood pressure, diabetes, obesity, cholesterol issues, strokes, and sudden heart attacks. All of them contribute to reducing life expectancy. As per WHO, Sleep apnea is linked to 10-30% of all motor vehicles due to dozing off during driving. Fatal events in public transport, killing innocent people, are connected with sleep apnea in drivers, and several countries have regulations to check this. Diagnosing sleep apnea remains the most critical health concern.

Think of sleep apnea symptoms as a low-battery smartphone: sleep apnea experience daytime fatigue, poor concentration, and productivity. However, diagnosing and treating sleep apnea restores a drop in oxygen at night, which can help to boost energy levels, cognitive function, and overall well-being, much like charging a low-battery phone can optimize its performance.

How serious your snoring can be screened by questionnaires like STOP-BANG or Epworth SleepScale or osas18 in children, but it’s reliably measured by a sleep test called polysomnography. Even smartwatches like Garmin, Apple, or Fitbit can reliably tell about the quality of your sleep. Children show different sets of problems with sleep apnea, like ADHD (daytime hyperactivity), underweight or overweight, low IQ, and study performance, and their dental and facial appearance changes as they become mouth breathers. They also run a higher risk of early hypertension and diabetes than normal children. However, in children, surgery on tonsils and adenoids fixes the sleep apnea problem in many children. Adults need a multidisciplinary team approach involving an ENT surgeon, pulmonologist, Neurologist, dietician, and maxillofacial dental surgeon. Treatments involve lifestyle changes (cutting down on alcohol and smoking) and weight loss, using a mask to give air under pressure, using dental guards to prevent tongue fallback, and exercises to improve the strength of tongue muscles and often surgery for selected patients.

Surgery has improved success by leaps and bounds due to newer diagnostics and a better understanding of the disease. Surgery involves a combination of procedures to open the nose, reduce palatal length, expand the face structure, and shrink the large tongue. New nerve-stimulating implants called hypoglossal implants (not available in India yet) have completely changed the game, with a more than 90% success rate. In short, evaluating snoring to diagnose sleep apnea is vital to prevent serious health problems (cardiac, metabolic, Neurological), enhance daily functioning, and promote overall physical and mental well-being.

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