BETTERING YOUR BEDTIME BLISS
While obstructive sleep apnoea (OSA) is more common among men than women, Dr Han Hong Juan says he has a low risk of having the breathing disorder because of his broad facial structure, holding a lot of air space.
“I’m not the fittest and I may not look good but I breathe very well,” quipped the Singaporean ear, nose and throat (ENT) surgeon. “I was interested in how other men, like my classmates, are very athletic but are likely to develop OSA. And I will outlive them if they don’t get treatment.”
Dr Juan is the medical director for the ENT, Voice & Snoring Clinic in the Lion City.
He was a guest speaker at the opening of the Philips Sleep and Respiratory Education Center that provides training for sleep specialists and technicians as well as healthcare professionals, to better diagnose and treat sleep disorders.
From a recent study, one in three Singaporeans suffers from moderate to severe OSA.
Men are more prone to having severe OSA due to the differences in fat distribution, upper airway anatomy, neurochemical mechanisms and sex hormones, among other factors.
“Because men are asleep, they are not aware of the persistent snoring and breathing problem whereas the partner is disturbed and worried,” he noted. “The wife may then record the husband while sleeping; only then will he realise that it’s a health issue and he needs to consult a doctor.”
But as women may not show classic symptoms, they may be under- or misdiagnosed with OSA.
Moreover, as some women seek aesthetic surgery for a sharper jaw and ideal face shape, the anatomical change may increase the risk of the breathing disorder and make them a “snoring beauty”. Craniofacial abnormalities, enlarged tonsils, allergic rhinitis and obesity also cause the sleep-related breathing disorder, even in younger people.
A sleep study will assess whether you have OSA by observing the snoring and breathing pauses when the upper airway collapses. In contrast, a snorer with normal breathing has a clear and open upper airway allowing air to flow freely to and from the lungs.
Other night-time symptoms include choking or gasping for air, restless sleep and frequent visits to the bathroom.
The loud snoring is not the problem, noted Dr Juan, who’s more concerned about the absence of sound.
“The silence means that there is no more air flow, and no air getting into the lung. And when a person is suffocating there’s no sound,” he said.
After waking up, symptoms during the day include early-morning headaches, sleepiness, poor concentration and irritability.
If left untreated, OSA may cause other health problems, such as cardiovascular disease, abnormal heart rhythm, high blood pressure, type 2 diabetes and stroke.
Dr Juan emphasises the need to generate awareness in order to get OSA patients diagnosed and started on treatment, such as with positive airway pressure sleep therapy devices that are now more simple, quiet and comfortable.
Masks f urther have revolutionary designs, such as a full face mask that enables wearing glasses, reading and watching TV; and a pillow mask with a hose on the top that allows more freedom of movement.
“You can have a high-tech device, but if the patient feels uncomfortable, that hinders compliance,” he said. “But it’s not just about the devices. More important, the patient needs expert care and Philips will develop this expertise at its Sleep and Respiratory Education Center.”