Want some expert advice but don’t know where to look? DNA seeks out experienced professionals who will answer your questions in simple language about a vast range of topics.
I’m a 38-year-old man suffering from diabetes and hypertension for the past 10 years. Although I keep strict control on my diet, I find that my doctor is increasing my medication to keep my blood sugar levels and blood pressure in check. I recently read on the internet that obstructive sleep apnoea (OSA) can cause diabetes and hypertension. My wife complains that I snore a lot at night. I wake up sweaty and tired and find it difficult to concentrate. Is there a connection between the two?
Your guess is probably right. Obstructive Sleep Apnoea (OSA) refers to the repeated collapse of the upper airway in sleep due to the hypotonia of the muscles which keep the airway open during sleep.
This results in the narrowing of the airway, thereby causing low oxygen concentrations in a cyclical fashion. These cyclical episodes cause a rise in blood pressure and the release of stress hormones in sleep.
Other nocturnal symptoms include breathlessness, choking, acidity and sleep talking. Daytime symptoms include fatigue, morning headaches, mood swings and decreased dexterity. OSA can lead to the development of hypertension, heart attacks, strokes, diabetes, obesity and even loss of memory.
I would suggest you seek the opinion of a sleep medicine consultant and undergo an overnight sleep study or polysomnography.
If you have OSA, you may be prescribed a Continuous Positive Airway Pressure unit which helps to regulate breathing in sleep and might control your diabetes and hypertension.
I’m a 19-year-old engineering student living away from home. Ever since I began staying at the hostel, I’ve been unable to get a good night’s sleep. I often stay up till late and manage to sleep only two-three hours at night. I feel sleepy throughout the day and it’s affecting my studies. What should I do?
There are two types of insomnia — sleep-onset insomnia where the patient faces difficulty falling asleep, and sleep-maintenance insomnia (SMI) where one wakes up too early and is not able to fall back asleep. You seem to be suffering from the former. Insomnia needs to dissected and evaluated to get favourable results.
Insomnia is often a result of associated medical disorders like mental depression, backache, heart disease or medications. Also, OSA (see above) may itself cause insomnia. Sometimes the problem may lie in the environment. A psychiatrist’s help may be necessary.
Proper history and sleep diaries help determine the cause. Consult a sleep medicine consultant to get to the root of your insomnia.
Dr S Ramnathan Iyer is consultant physician and consultant, sleep medicine, at Ambika Clinic, Dombivli, and Dr LH Hiranandani Hospital, Powai
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