Apnoea is a Greek word means “without breathing” It is basically disorder of sleep which is considered by pauses’ in breathing and period of shallow/ irregular inhalation while sleeping. It can precede for a few seconds to quite a lot of minutes and they happen several times, in night. It can happen 30 times or much more in an hour. In the supreme common form, this follows loud snoring, it occurs when the movement of mouth or nasal passage is physically blocked. Men, overweight people, and people over age of 40 are at greater risk of sleep apnoea [1]. Sleep apnoea is triggered by airways that are being congested by a tongue that relax, and other factors include, hypertension, obesity, diabetes, cardiac disorders etc [2].

Signs and symptoms

Health risk factors linked with sleep-apnoea are enlarged tonsils and tongue, overweight, obesity, larger size of the neck (17 inches or more in men) and smaller jaw bone. In addition when oxygen levels in the blood is low then the vessels of blood in lungs lead to constriction and eventually cause pulmonary hypertension [3]. Chronic headaches, astroesophageal reflux, daytime sleepiness, heart attack and different heart related stroke will occur when blood pressure is high and may cause many heart related disorders. Besides uncomfortable night’s sleep leading to day drowsiness, inhibiting our quality of life and causing nasal obstruction due to a deviated septum, allergies, or sinus problems [4].

Hypertension induced sleep apnoea

As sleep apnoea may contribute to high blood pressure i.e., (systolic, diastolic), mean systolic plus diastolic blood pressure increased by increasing sleep disorder measures and its association with body mass index BMI [5,6]. Race and smoking usually associate/linked with sleep disorder and hypertension. This association decreases as the age decreases [7].

Obesity induced sleep apnoea

Obesity increases the possibility of sleep-apnoea. Sleep apnoea may dispose to weight gain and it was found that obese patients which were recently identified with sleep apnoea had a history of recent weight gain in the period prior to the diagnosis [8]. People with 10% increase of standard weight are at increased risk of developing sleep apnoea. However a corresponding weight loss can result in 20% more improvement in severity of sleep apnoea. Fat deposition nearby upper inhalation route in the tissue appears to result in an enlarged collapsibility of the upper passage and smaller the size of lumen predisposing to apnoea [9]. When fat deposition surrounds the thorax (trance obesity) it reduce functional remaining capacity, chest obedience and may need higher oxygen demand [10].

Diagnosis

Symptoms of sleep-apnoea should be identified, doctor might asked that patient must need a sleeping test, named a “polysomnogram” this is a multiple component test in which detailed records of all the physical activities done during sleeping hours are monitored. This might be processed in a sleep disorder center or at home. The specific recordings are examined by a qualified doctor or sleep-specialist to conclude either patient have sleep-apnoea or another type of sleeping disorder [11]. If sleep apnoea is determined in the patient then a patient can requested to do more sleeping tests in order to conclude further greatest treatment options. However, polysomnogram is complex and costly procedure thus limiting its practical applicability for the treatment and evaluation of sleep apnoea. Therefore, less costly methods have been devised that can be can be applied at patients home by avoiding alcohol, sleeping pills, losing weight, quit smoking, changing sleeping position for easy breath in and breath out [12].

Treatment

When treatment of sleep apnoea fails due to non-surgical methods then proper surgery is needed [13]. Uvulopalatopharyngoplasty is directed at physically removing the tissue of the throat that may obstruct breathing when patients asleep, removing the increased palatal or pharyngeal tissue [14]. Soft tissue, tonsils, uvula and any type of extra tissue is removed from the back of the throat. Surgery increases the size of the airway so that it is more difficult for it to close completely. Surgery requires general anesthesia and an overnight hospital stay, and recovery is prolonged, so it is not an ideal choice for every patient [15]. Uvulopalatopharyngoplasty patients receive less follow-up care after undergoing the surgery. Tracheotomy, a less common surgical therapy/ technique used to treat sleep apnoea. In tracheotomy system the tracheal gap is not kept open for the duration of the day an attachment is utilized to inhale through the nose and mouth, the module turn is evacuated/removed around night time so that the air penetrates straightforwardly into the distal portion of the trachea [16]. However, tracheostomy may be rejected by many patients because of the “social and permanent maintenance problems involved” with having a visible opening in the neck and preventing it from closing over time [17]. It is often a treatment of last resort after Uvulopalatopharyngoplasty has failed to produce lasting results. Tracheostomy can be a dangerous procedure in obese patients (and many sleep apnoea patients are obese). Recurrent respiratory infections are also observed in patients who have undergone a tracheostomy. In grown-ups men’s the hypertrophic tonsils can be a main consideration in sleep apnoea in serious instances of obstructive tonsils likewise called as tonsillectomy give benefits and positively affect the piece of the upper aviation route and it happen at any age [18]. Radiofrequency removal of the tonsils is another strategy in light of electromagnetic radiation through energy transfer to era of warmth with in the tissues. It is utilized to accomplish a decrease in tissue by volume took after by healing, and can be go with by comparative treatment of the base of the tongue. Clinical trials can propose less pain with radiofrequency methodology than with aggregate specific surgery [19].

Researchers support future research on the issue, especially around the impact of sleep apnoea. In spite of the fact that discoveries are promising, bigger reviews are required to evaluate the medical health of patients with sleep apnoea. By recognizing the best combination of treatments for patients with sleep apnoea, the relative prevalence of this sleep complication may be reduced.