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Sleep Apnea: Know your sleep problem before its too late

Sleep Apnea
Dr Vikram Rathi

Dr Vikram Rathi is a successful chest physician who works with Rathi Chest Clinic, CARE Hospital and SEVEN STAR Hospital in Nagpur. Read one of his articles, where he speaks about one of the major sleep disorders – Sleep Apnea. 

Sleep medicine did not even exist until the Japanese decided to save marriages. The story goes that about 30 years ago, a Japanese court granted divorce to a woman on grounds that her husband was snoring. The early work on sleep medicine therefore came from Japan and it was intended, even if not to save lives, to save relationships. Snoring, however, is just not a standalone. In most cases, about 90 per cent snoring is indicative of a condition called sleep apnea.

Sleep apnea is one of the many sleep disorders. Obstruction to breathing during sleep is defined as apnea, and its cardinal symptom is loud snoring. The prevalence in India is about 24 per cent of men (mostly over 40 years) and nine per cent of women.

Post 40s, the bodys muscle loses its tonality, especially among men with little physical activity. During sleep, when the muscles relax, the base of the tongue completely obstructs the airway, causing the breathing activity to cease.

Sleep disorders represent a significant number in India, yet, it is an overlooked health problem Sleep apnea is a form of sleep-disordered breathing, in which the airway becomes narrowed as the tissues and muscles surrounding it relax. The brain corrects for this suffocation by jerking the patient between deep sleep and light sleep, and even momentary awakening, though the individual doesn’t necessarily remember it. Many of us are living with sleep apnea unaware and it is estimated that 80-90% remain undiagnosed

Untreated, OSA has been found to significantly raise the risk of developing diabetes, high blood pressure, heart disease, heart attack and stroke. It majorly impacts quality of life, patients are sleep deprived, feel sleepy all the time, there is dulling of the intellectual and emotional faculties of a person, often feel depressed and terrible. Many of the major industrial or transportation accidents in the past few years have been linked to sleep deprivation or OSA. It is crucial to treat this to protect your heart health.

Sleep apnea is recognised as a disorder in the West. In some countries, those with sleep apnea will not be issued driving licenses, or allowed to work with heavy machinery. That kind of awareness is lacking in India. There is a strong suspicion that Indians are genetically more predisposed to sleep apnea, research says. Sleep apnea among children is also growing. In them, while the causes relate to tonsils or adenoids, and removal is the recommended option.

What is the underlying cause of sleep apnea?                                                                         There are a lot of different theories, but the general principle is that the airway gets narrowed due to tissue/muscle obstruction. Your body usually has a sense when the airway is being narrowed, but after a while the nerve endings can get less sensitive, especially as people get older, many people gain weight and lose muscle tone. Women are at higher risk post-menopause due to hormonal changes. Growing obesity, changing lifestyle patters, overeating, sedentary life, smoking, consumption of alcohol are few of the causes for Sleep Apnea

Research has identified a set of risk factors associated with sleep apnea. Major risk factors include being male, being obese, having a history of hypertension and diabetes, and having a family history of sleep apnea. People who snore loudly are also more likely to have sleep apnea.

Signs and symptoms:

One of the major red flags to be on the alert for is snoring.

Snoring is considered a partial obstruction or blockage of the airway, and many times it is only the bed partner who realises that the individual snores. Other warning signs are daytime tiredness, not feeling like you’ve gotten enough sleep when you get up, headaches, irritation, mood changes, frequent urination at night, morning headaches, inability to concentrate, and things related to sleep deprivation, like falling asleep at the wheel or falling asleep in meetings

Being Male, Overweight, Older, a Snorer and Excessively sleepy (MOOSE) are the typical risk factors for OSA. However, you can be thin and young female, who doesn’t snore and be sleepy, and still suffer from obstructive sleep apnea due to smaller jaw structures and smaller upper airways.

The diagnosis and management of this condition is rapidly evolving. Fortunately, with the proper tools, OSA can be diagnosed ? and, with proper treatment, risks for conditions associated with OSA can be significantly reduced.

The Sleep Lab

When being evaluated for OSA, it’s recommended you see a sleep physician. Most sleep physicians will be pulmonologists or other physicians who undergo subspecialty training in sleep medicine.

Often, a sleep study will be suggested. However, for some, sleeping overnight in a strange place with wires hooked up can be a barrier to getting tested. Fortunately, there are other options. In some instances, simpler home tests can also be ordered.

If you’re found to have sleep apnea, there are a number of different, effective treatment options, including conservative methods, medical devices and, in some cases, surgery.

Initial Conservative Steps for Treating OSA:

  1. Lose weight. If you’re overweight, start by losing weight through a healthy diet and exercise regimen. While it’s been shown that lack of sleep can make it hard for someone to lose weight, losing even 5 to 10 pounds can help.
  2. Don’t eat late. Eating close to bedtime will increase acid reflux in your throat every time you stop breathing; this is due to a suctioning effect. It’ll wake you up more often and lessen your sleep quality.
  3. Breathe well nasally. Optimal nasal breathing is important so you don’t open your mouth, which causes your tongue to fall back more, leading to more obstructed breathing. Good nasal breathing also significantly improves your chances of doing well for more formal OSA treatment options. Chinstraps or mouth taping can sometimes help.
  4. Do tongue exercises. Researchers from Brazil found that a regimen of tongue exercises lowered the severity of OSA by about 50 percent.
  5. Don’t sleep on your back. Most people with OSA won’t be able to sleep on their backs since the tongue falls back due to gravity. When in deeper levels of sleep, the tongue and throat muscles become even more relaxed. If you’re a side or tummy sleeper and are suddenly forced to sleep on your back (due to an injury or surgery), try to go back to your previous sleep position as soon as possible.

If these conservative steps don’t work, there are other options to consider:

Continuous Positive Airway Pressure, or CPAP: Gold standard of therapy is CPAP. Gentle air pressure is passed through a mask over your nose (or nose and mouth), attached to a quiet and small bedside pump. This allows you to breathe properly at night. The best pressure is either measured in a second overnight sleep study (CPAP titration). With proper guidance from chest physician, most people can sleep much better at night.

Mandibular advancement device. These devices are recommended for people with mild to moderate OSA and can be considered as first-line therapy, in addition to CPAP.

Surgery. Before 1980, the only option available for OSA was a tracheotomy. Now, there are dozens of different surgical options for various areas and types of obstruction, from the tip of the nose to the voice box. However, surgery should be considered only after trying one or both the above options.

Since everyone has different levels and degrees of obstruction, there’s no one option that’s best. It’s important to work with your doctor to determine what’s most ideal for each individual situation. If you are at risk for OSA or exhibit any signs or symptoms, get tested.

Questions for your doctor:

There’s no harm in asking, Am I at risk of sleep apnea?? If your partner complains about your snoring, then ask, Am I a candidate for a sleep study?? If you are diagnosed with sleep apnea, the question becomes, How severe is my sleep apnea?? and ?What treatment options do I have??

Sleep apnea and snoring can affect your day-to-day quality of life and your bed partners quality of life, apart from other health risks. Having sleep apnea treated is crucial, both medically and in terms of your quality of life.

Don’t ignore symptoms. And that includes feedback from your partner. You can’t hear yourself snoring or when you stop breathing, but your partner can, If you sleep alone, be alert for symptoms and don’t hesitate to ask your doctor if you are a candidate for a sleep study.

Take preventive steps. Maintaining a healthy weight, sleep hygiene, avoiding alcohol and other sedatives at night cuts your risk of sleep apnea.

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Indie singer Prateek Gandhi’s ‘Naina Ri Patang’ unlocks emotions, charms fans | Interview

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Avani Arya | Nagpur

Indie singer Prateek Gandhi in conversation at Dialogue @ Nation Next, speaks about his musical journey, his fans, and his upcoming releases and much more.

Also Watch: Just because you don’t like Mr Modi doesn’t mean India is under threat: Harish Salve | Interview

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Nagpur News

November 30, 2022 | Nagpur News | नागपुर समाचार | Hindi News Bulletin | Nation Next

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Avani Arya | Nagpur

Nation Next Nagpur Bulletin brings to you a summary of major news events that took place in Nagpur on November 30, 2022.

1. मुंबई में हुई cabinet की meeting में प्रधानमंत्री आवास योजना के beneficiaries को सिर्फ 1 हजार रुपए में रजिस्ट्री करने का decision लिया गया है. नागपूर के mla कृष्णा खोपड़े ने यह मांग की थी.mla खोपड़े के मुताबिक़ कुछ दिन पहले प्रधानमंत्री आवास योजना के beneficiaries ने उनसे मुलाक़ात की थी और 1 हजार रुपए में रजिस्ट्री कराने की व्यवस्था करने की मांग की थी. इसके बाद खोपड़े ने 6 september 2022 को Revenue Minister राधाकृष्ण विखे पाटिल को letter लिखा और बाद में 11 नवंबर को deputy cm फडणवीस को letter दिया. इस दौरान letter में यह कहां गया कि जैसे झोपड़पट्टी के लोगों को फ्री में रजिस्ट्री की व्यवस्था की गई है, उसी तरह प्रधानमंत्री आवास योजना के beneficiaries को हजार रुपए में रजिस्ट्री करने की व्यवस्था की जाए. इस मांग को state government ने मान लिया है.

2. आपने नागपुर शहर में देखा होगा की कुछ महीने पहले बनी सीमेंट roads को नल के पाइपलाइन और गटर line के काम के लिए तोड़ा जा रहा है. इसके विरोध में बुधवार 30 नवंबर को युवक कांग्रेस ने प्रोटेस्ट किया. ‘ घंटा बजाओ, नागपुरवासियों का टैक्स बचाओ ‘ के नाम से यह प्रोटेस्ट किया गया. बंटी शेलके के lead में इस प्रोटेस्ट में नागपुर Municipal Commissioner राधाकृष्णन बी, cm एकनाथ शिंदे और Deputy CM फडणवीस के मास्क पहनकर प्रोटेस्ट किया गया.

3. नागपुर के गिट्टीखदान पुलिस स्टेशन के तहत आनेवाले बोरगांव दिनशॉ फैक्ट्री के सामने वाली बस्ती में 3 महिलाओ के साथ मारपीट का video वायरल हो रहा है. यह घटना शुक्रवार 25 नवंबर की है. इस मामले में आम आदमी पार्टी के लोगों ने पुलिस स्टेशन पहुंचकर आरोपियों पर सख्त कार्रवाई करने की मांग की है. आम आदमी पार्टी कार्यकर्ताओ के मुताबिक़ पुलिस ने अब तक किसी पर भी कोई concrete कार्रवाई नहीं की है. जबकि अलका उईके नाम की महिला के साथ बहोत ज्यादा मारपीट आरोपी चंदन सडमाके ने की है. जानकारी के मुताबिक़ जिनके साथ मारपीट हुई है वो 3 महिलाएं जब गिट्टीखदान पुलिस स्टेशन पहुंची तो सिर्फ एक महिला की complaint ली गई. इस मामले में 354 के तहत अपराध दर्ज होता है, लेकिन पुलिस महिला से कह रही है कि हमने उसको समझा दिया है, अब वो कुछ नहीं करेगा. video में देख सकते है कि एक आदमी महिला के साथ किस तरह से मारपीट कर रहा है. जानकारी के अनुसार इसमें पुलिस ने सिर्फ nc मामला दर्ज किया है. देखने में आया है की शहर पुलिस की इसी लापरवाही के चलते कई बड़े -बड़े हादसे बाद में होते है. समय रहते पुलिस किसी भी मामले में सख्त कार्रवाई करे, तो सामने होनेवाले serious crime को रोका जा सकता है.

4. नागपुर के सदर में Bishop Cotton स्कूल में बुधवार को स्कूल के खिलाफ parents ने नाराजगी जाहिर की . बुधवार 30 नवंबर को सुबह ही parents स्कूल के सामने जमा हो गए. parents ने स्कूल की headmistress शुभदा टिमोथी के खिलाफ नाराजगी की है और parents का यह कहना है कि इनकी appointment ही illegal तरीके से हुई है .कुछ दिन पहले parents ने स्कूल की headmistress के खिलाफ नागपुर के Education Officer को भी written complaint दी है. parents का कहना है कि स्कूल headmistress का बर्ताव parents और management के साथ बिलकुल भी अच्छा नहीं है. parents के साथ उन्होंने कई बार arrogantly बात की है. parents ने यह मांग की है कि स्कूल की CBSE की principal maudlin तिवसकर को nursery से लेकर 12th तक का स्कूल का पूरा चार्ज दिया जाए. parents का कहना है की headmistress टिमोथी के कारण उनके बच्चों की study का नुक्सान हो रहा है. आज parents ने school के management से बात की और उन्हें अपनी problems बताई.

5.  29 नवंबर को नागपूर के मेडीकल कॉलेज में ragging का एक मामला सामने आया है. जिसमें 6 students के खिलाफ कार्रवाई करके उनकी Internship cancel की गई है. इसके साथ ही इन students के खिलाफ पुलिस में complaint दर्ज की गई है. जानकारी के अनुसार mbbs के first year students के साथ ragging का video सामने आने के बाद कॉलेज में सनसनी मच गई थी. इसके बाद central ragging commitie ने इस मामले में मेडीकल कॉलेज को complaint करते ही यह कार्रवाई की गई. दरअसल मेडीकल administration को central ragging commitie की ओर से एक video mail किया गया था., जिसमे 6 intern students mbbs के एक first year student की ragging कर रहे थे. इस वीडियो के मिलने के बाद मेडीकल administration ने तुरंत एक meeting ली और investigation के order दिए. investigation में पता चला कि video सही है. इन students को hostel से भी बाहर कर दिया गया है. कल रात तक यह कार्रवाई जारी थी.

6. रेलवे पार्सल department की ओर से सामान इस शहर से दूसरे शहर भेजा जाता है. कई बार रेलवे कर्मचारी और मजदुर इसमें काफी लापरवाही करते है, कई लोगों के महंगे -महंगे सामान भी रेलवे मजदूरों के उठाने और रखने से टूट जाते है. लेकिन रेलवे department इन गैरजिम्मेदार मजदूरों और रेलवे कर्मचारियों पर किसी भी तरह की कोई कार्रवाई नहीं करता है. ऐसा ही एक मामला मंगलवार 29 नवंबर को सामने आया है. दरअसल एक व्यक्ति ने नागपूर से अपने बेटे के लिए moped लातूर के लिए भेजी थी , लेकिन इसको लातूर में न उतारते हुए इसको कोल्हापुर में उतारा गया. जिसके कारण इस व्यक्ति को काफी परेशानियों का सामना करना पड़ा. जानकारी के मुताबिक़ गणेशपेठ में रहनेवाले m. अग्रवाल ने एक moped 24 नवंबर को नागपुर के पार्सल department से महाराष्ट्र एक्सप्रेस में लातूर भेजी थी, उनका बेटा वहां पढ़ाई कर रहा है. लेकिन लातूर पहुंचने के बाद इसको लातूर में नहीं उतारा गया. जब मोपेड नहीं मिली तो बेटे ने अपने पिता को फ़ोन पर जानकारी दी.इसके बाद अग्रवाल ने जब पता किया तो उन्हें पता चला की मोपेड कोल्हापुर पहुंच गई है. रेलवे ने अग्रवाल को यह जानकारी दी की लातूर में ट्रेन से नीचे मोपेड उतारनेवाला कोई नहीं था. इसके बाद यह भी कहां गया कि अगर फिर से लातूर में कोई मोपेड उतारनेवाला नहीं मिला तो मोपेड वापस आएगी. अग्रवाल ने strict होकर गाडी उतारने को कहा, उन्होंने railway helpline पर complaint भी की, इसके बाद मोपेड को लातूर में उतारा गया. रेलवे के पार्सल department की लापरवाही के कारण कई लोगों को रोजाना ही mentally और physically harrass होना पड़ता है. कई मामले सामने आते है तो कई मामले सामने ही नहीं आते है.

Script by – Shamanand Tayde

Also Watch: November 28, 2022 | Nagpur News | नागपुर समाचार | Hindi News Bulletin | Nation Next

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Senior journalist Ravish Kumar quits NDTV India

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Radhika Dhawad | New Delhi
Senior Journalist Ravish Kumar quit from his post as Senior Executive Editor at NDTV India on Wednesday, November 30.

Ravish Kumar

Senior Journalist Ravish Kumar quit from his post as Senior Executive Editor at NDTV India on Wednesday after the news channel informed the Bombay Stock Exchange in a regulatory filing that its founders Prannoy Roy and Radhika Roy have resigned as the directors of RRPR Holding Private Limited.

Suparna Singh, President, NDYV Group said Kumar’s resignation was effective immediately. Singh, through an email, stated, “Few journalists have impacted people as much as Ravish. This reflects in the immense feedback about him: in the ‘crowds he draws everywhere; in the prestigious awards and recognition he has received, within India and internationally and in his daily reports, which champion the rights and needs of those who are under-served.”

Singh added that Kumar had been an integral part of NDTV for decades and that his contribution has been immense. She said, “We know he will be hugely successful as he embarks on a new beginning.”

In September 2019, Kumar won the prestigious Ramon Magsaysay Award for ‘harnessing journalism to give voice to the voiceless.’ The Ramon Magasaysay Foundation said Kumar was being recognised for ‘his unfaltering commitment to a professional, ethical journalism of the highest standards; his moral courage in standing up for truth, integrity, and independence; and his principled belief that it is in giving full and respectful voice to the voiceless, in speaking truth bravely yet soberly to power, that journalism fulfills its noblest aims to advance democracy.’

Kumar used to host a number of programs including the channel’s flagship weekday show Hum Log, Ravish ki Report, Des Ki Baat and Prime Time. He has also been conferred with the Ramnath Goenka Excellence in Journalism Award twice.

Prannoy and Radhika Roy resigned as the Directors on the board of RRPR Holding Private Limited, the company said in a regulatory filing on Tuesday. The board of RRPR Holding has approved the appointment of Sudipta Bhattacharya, Sanjay Pugalia and Senthil Sinniah Chengalvarayan as Directors on its board with immediate effect.

The move came after the Gautam Adani-led Adani Group acquired 29.18% stake in television channel NDTV Ltd on August 23 and said it would launch an open offer as required by the Securities and Exchange Board of India (SEBI) to buy another 26% in the company. On November 22, the Adani Group launched its open offer, which is to remain open until December 5, 2022

Also read: Tata Sons, Singapore Airlines to merge Vistara, Air India by March 2024

 
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