By:-Dr Satyanarayana Mysore
Sleep apnea is increasing in its prevalence in India. Sleep apnea is a syndrome in which upper part of airway repeatedly collapses during sleep. Numerous factors like obesity, hormonal imbalance, medications, alcohol, smoking, sedatives and body position are all implicated as factors in developing sleep apnea.
Currently CPAP (continuous positive airway device) remains as standard of care. Many cannot tolerate and some patients cannot afford such devices. Alternatives to CPAP include Surgery of palate and upper airway, mandibular advancement splint- a device that pushes lower jaw forward and this results in airway remaining marginally open, tongue stabilising devices and occlusion devices. Some of these therapies are yet to undergo the rigor of clinical trials.
A bed partner prompting to move the patient to their side has been one of oldest observations that can result in stopping snoring.
A good quality sleep study done overnight will aid in recognition that some patient’s sleep apnea is much influenced by supine position (lying down on the back). Once this is recognised, it is important to educate the patient and try lifestyle changes, weight management and position changing devices.
A simple elevation of head end by 30 degrees (one additional pillow) can ensure that upper airway remains relatively more open during sleep. Sleep is a dynamic stage in which generally muscles lose tone except in eyeball muscles.
Position changing devices:
“A sleep ball” wherein, a pocket is created in the patient’s night dress in the shirt’s front and back. A soft ball may be placed in a sock and these could fit into these pockets on the shirt’s front and back.
This remains traditional and cost effective measure to ensure that patient does not sleep on his/ her back, but on the sides.
Similar devices in the today’ s technology driven world is actually patented in Adelaide- Australia.
The device is called as “Buzzpod “and is prescribed after sleep study that confirms posture related sleep apnea in HCL Healthcare- home sleep studies.
Traditional Sleep Ball
Buzzpod Device: This device consists of a belt (Buzzer unit) and a computerised program.
It records sleep position and can “Buzz” the patient whose tries getting into on to his back.
Dr Satyanarayana Mysore, sleep and Pulmonologist trained in India and Abroad is keen to bring in alternatives to CPAPs and works as head of pulmonology in HCL Healthcare.