Sleep Apnea: When You Stop Breathing While Sleeping — The Hidden Epidemic in Hyderabad

Obstructive sleep apnea (OSA) is a sleep disorder in which the upper airway repeatedly collapses during sleep, causing episodes of stopped breathing (apneas — lasting 10 seconds or more) and reduced breathing (hypopneas) throughout the night. Each event causes oxygen levels to fall and carbon dioxide to rise, triggering an arousal from deep sleep — too brief to be remembered but sufficient to fragment sleep architecture and prevent restorative sleep. In severe OSA, these events can occur hundreds of times per night.

Symptoms

Night symptoms: Loud, habitual snoring; witnessed apneas (the partner sees breathing stop); gasping or choking arousals; restless sleep; nocturia (waking to urinate — caused by the increased intrathoracic pressure during apneas triggering atrial natriuretic peptide release). Morning symptoms: Non-refreshing sleep; morning headache (from CO2 retention during night apneas); dry mouth. Daytime symptoms: Excessive daytime sleepiness (the STOP-Bang questionnaire is a validated screening tool); cognitive impairment — memory, concentration, executive function; mood disturbance; increased accident risk (driving and occupational).

Neurological and Cardiovascular Consequences

Untreated OSA: doubles the risk of stroke; causes hypertension (OSA is the most common secondary cause of hypertension — frequently missed); increases risk of atrial fibrillation; causes intermittent hypoxia that directly damages brain white matter, hippocampus, and prefrontal cortex. OSA is a strong independent risk factor for Alzheimer's disease — impaired glymphatic clearance of amyloid during fragmented sleep is a proposed mechanism.

Diagnosis and Treatment

Home sleep apnea test or polysomnography (sleep study): records oxygen saturation, airflow, respiratory effort, and EEG during sleep. Severity: mild (AHI 5–15/hour), moderate (15–30/hour), severe (above 30/hour). CPAP (Continuous Positive Airway Pressure): the gold standard treatment — a mask delivering pressurised air to hold the airway open during sleep. Transformative in severe cases. Alternatives: mandibular advancement device (for mild-moderate); weight loss (essential adjunct); positional therapy (for positional-predominant OSA); surgical options (tonsillectomy in children; uvulopalatopharyngoplasty). Sri Anand CNC, Chanda Nagar, Hyderabad. Call +91 90633 66983.