Heart failure

Dr Prince James, Naruvi Hospital, Health News, ET HealthWorld


Shahid Akhter, Editor-in-Chief, ETHealthworld, spoke with Dr Prince James, Chief of Interventional Respirology, Naruvi Hospital, Vellore, to learn more about the challenges and latest advances associated with OSA.

Impact of Covid-19 on hospitals and patients
Over the past year and a half, we and our country and around the world, I think we have all undergone a drastic change in our routine activities and have seen the disastrous first wave as well as the second wave of COVID and it has affected all areas of our life including our daily activity of which sleep is an important part and we all need to have a history whether we have experienced COVID in our home or in the neighborhood and too often we were stressed from COVID, many of us, our friends, family members were suffering from COVID.

Especially the people in our country who are suffering from metabolic disorders like diabetes and blood pressure, heart disease, stroke, all that stress and lack of sleep related to COVID has affected every part of their life and many people have developed uncontrolled diabetes, blood pressure has increased, and COVID itself has caused a lot of blood sugar spikes along with a lot of coronary heart disease and stroke, which happens because of COVID, c So is the impact of COVID and other issues on COVID because hospitals were completely filled with COVID patients, we have not been able to provide routine services to other patients who come there with other illnesses such as COPD, asthma, respiratory illnesses, sleep disorders; all these investigations, management, everything stopped during that one and a half year period.

OSA impacting other conditions
As far as sleep apnea goes, it actually starts with snoring and I know we all have to have a family member in our family who used to snore and sometimes we would laugh or snore each other. self and obesity is another thing, what we are witnessing now in our country and around the world. We know obesity is now a pandemic around the world and India is not far either. Even in children in schools, it is noticed that children’s BMI increases and with this a disease appears, called obstructive sleep apnea syndrome (OSA) and this disease mainly occurs in people who are overweight or those who are obese and those with a history of snoring. It’s happened all over the world and people have noted it and the medical fraternity has noted it and the patients have been tested, diagnosed, but as far as India goes, there’s a lot, you know, of general public awareness because usually we laugh at the snoring and although it affects their spouse’s sleep, but we just laugh at it and go. We don’t worry about it, but it affects our sleep and it has a lot of bad effects, which changes our metabolism and it has led to many other disorders like diabetes, blood pressure, heart disease, stroke cerebral conditions, which are irreversible conditions. . Although sleep apnea is a reversible thing, you can control it, you can treat it, you can live a normal life with it, but if we don’t treat it, we fail to diagnose it, it leads to heart failure and stroke and we know these things are irreversible. Once they develop we can only control them, we can try to bring the patients back to usual life but we cannot bring the organ functions back to normal and that is the importance of knowing the Sleep apnea and its management, treatment and much awareness has to bring in our country regarding obesity and snoring and its effects on sleep.

AOS: Advances
When it comes to obstructive sleep apnea syndrome, there has been a lot of progress over the past few years, as the diagnostic test is a sleep test, so we have to sleep at night and usually this is done in the lab. sleep, so we have to go to the hospital in the evening at 7 or 8 o’clock, we sleep there all night, and the test automatically records all the results and in the morning we get up and come back, but still we have to pass one night in the hospital.

Now there are tests available, which can be done at home. It’s sort of a screening test. The initial test can be done at home. We can do the test for a day or three days, get the diagnosis, and if the diagnosis is confirmed, based on this report and recording, the doctors can make the decision to start treatment or do other things. tests to accurately diagnose sleep apnea and then start treatment, so this is the advancement of the diagnosis. Treatment too, there is a lot of progress now that is better. The treatment for sleep apnea syndrome is actually what happens during sleep, our airways in the pharyngeal area, in the upper part of the neck, collapse and that is why the air flow s ‘stop and our oxygen saturation goes down and that has an effect on the whole body because our body runs on oxygen.

Treatment is a device that can push air out with pressure so that our airways stay open during sleep as well. The device is called CPAP, which is positive pressure ventilation and comes in several forms. So, over time, new machines have appeared, which can provide more comfortable treatment to patients, which has evolved over time and these, the equipment can now be available in our country as well, in order to provide better treatment and a better quality of life for patients. Other advances are still in progress. We are always on the lookout for a medicine that can help our patients. We do not yet have a drug, a pill to treat this disease.

There are other advances such as mandibular advancement devices. These are the devices, which are put in the mouth, fixed in the mouth during sleep to help patients. However, the acceptance among the patients is not that great. There is a lot of work to be done in this area. Previously, some surgeries were performed for this disease, but recurrence rates are high, so surgical treatment is still not the main treatment. The main treatment is positive pressure ventilation therapy, that is, CPAP or BiPAP is currently the treatment for OSA. Weight loss is an important part of it and we must try to lose weight as it can help us and improve our sleep apnea problem and the study shows that patients who use CPAP have a very high chance of losing more. weight. than people who are just trying to lose weight without using CPAP therapy. CPAP not only helps in improving our sleep but also in reducing our weight so that we can have better sleep and the symptoms of sleep apnea syndrome can be alleviated.


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