Sleep Apnoea
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Definition Sleep Apnoea is a serious sleep disorder where a person stops breathing for short periods during sleep.
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Causes / Etiology The causes of sleep apnoea include:
- Obesity
- Narrow throat or airway
- Family history
- Age (over 40 years)
- Smoking
- High blood pressure
- Large tonsils or adenoids
- Sleep position (sleeping on back)
- Types or Classification There are three main types of sleep apnoea:
- Obstructive Sleep Apnoea (OSA) - blockage of airway
- Central Sleep Apnoea (CSA) - brain fails to send signals to breathe
- Mixed Sleep Apnoea - combination of OSA and CSA
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Pathology Here's a step-by-step explanation of the pathology: Step 1 → Relaxation of muscles in the throat Step 2 → Narrowing of the airway Step 3 → Blockage of airflow Step 4 → Oxygen levels in the blood decrease Step 5 → Brain fails to send signals to breathe (in CSA) Step 6 → Breathing stops for short periods Step 7 → Breathing resumes with a loud snort or gasp
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Clinical Features General features:
- Loud snoring
- Morning headaches
- Fatigue
- Difficulty concentrating
- Irritability Specific features:
- Pauses in breathing during sleep
- Breathing resumes with a loud snort or gasp
- Noisy breathing
- Complications Acute complications:
- Respiratory failure
- Cardiac arrest
- Hypoxia Chronic complications:
- High blood pressure
- Heart disease
- Type 2 diabetes
- Osteoporosis
- Diagnosis / Investigations Routine tests:
- Physical examination
- Medical history
- Sleep diary Special tests:
- Sleep study (polysomnography)
- Oximetry
- Arterial blood gas analysis
- Management General management:
- Weight loss
- Sleep position change
- Quit smoking
- Reduce alcohol consumption Modern treatment:
- Continuous positive airway pressure (CPAP) therapy
- Oral appliances
- Surgery (e.g., uvulopalatopharyngoplasty)
- Lifestyle changes (e.g., exercise, stress management)
- Homeopathic Therapeutics Here are 4-5 main remedies with their keynotes:
- Lachesis:
- Keynote: Suppressed emotions
- Symptoms: Snoring, morning headaches, fatigue
- Indication: Obstructive sleep apnoea
- Sanguinaria:
- Keynote: Anxiety and stress
- Symptoms: Difficulty concentrating, irritability, insomnia
- Indication: Central sleep apnoea
- Kali bromatum:
- Keynote: Emotional instability
- Symptoms: Mood swings, anxiety, snoring
- Indication: Mixed sleep apnoea
- Silica:
- Keynote: Constitutional weakness
- Symptoms: Fatigue, weakness, snoring
- Indication: Obstructive sleep apnoea
- Phosphorus:
- Keynote: Emotional sensitivity
- Symptoms: Anxiety, stress, insomnia
- Indication: Central sleep apnoea