DR. SUPRATIM DEB ROY, PGT, DEPARTMENT OF ANAESTHESIOLOGY AND CRITICAL CARE, SMCH
INTRODUCTION
Obstructive sleep apnea is the most common type of sleep disordered breathing. SDB refers to respiratory signs and symptoms associated with sleep associated respiratory dysfunction and is defined by the occurrence of respiratory events which are cessations in breathing rhythm or momentary or sustained reduction in the amplitude of respiratory flow during the sleeping state, leading to arterial hypoxemia.
CASE DESCRIPTION
A 46-year obese female came to OPD with chief complaint of difficulty in breathing and bilateral swelling of both legs for past two to three months. On eliciting history patient revealed she has features suggestive of obstructive sleep apnea: history of snoring, falling asleep during monotonous situations, apneic spells witnessed by husband at night. Patient also gave history of hypertension for past one year for which she is on tab amlodipine 5 mg once daily along with history of type 2 diabetes mellitus on tab metformin 500mg. On examination BP= 140/94 mmHg, PR = 85 bpm. Laboratory investigations showed HbA1c 7.6%, LDL 176mg/dl, TGL 163 mg/dl, ABG: pH – 7.28, PaCO2 – 48 mmHg, PaO2 – 62 mmHg, HCO3 – 18mEq/L, SaO2 – 89%
CONCLUSION
The hallmark of OSA is sleep induced and arousal-relieved upper airway obstruction. The lack of oxygen caused by OSA leads to increased health risks as seen in this patient along with depressive illness, cognitive impairment and even mortality if not treated so focusing on early detection and treatment is crucial.OSA though common typically goes undiagnosed. The diagnosis can often be established based on clinical history and examination alone. The two most widely available treatments for OSA are continuous positive airway pressure and weight loss. Other modes of treatment include – medications, surgery. All modes of treatment should include treating comorbid conditions, patient education and long term follow up.
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