Hey man, what’s up, you seem down and out. Why the sad face?

I’m sorry to hear that, man.

Take it easy bro, I am sure we can find a solution to this.

Thaaththi is a Chest Specialist, and I’ve heard him talk about things like this. Why don’t we ask him about this? I’ll tell you what, why don’t you come over one of these days and talk to him. The best time to catch him is around twelve midnight.

Hello Sandun! Come in, have a seat. I’ve been hearing about the problems you have been having. Let’s have a chat, I’m sure we can sort things out.

No problem, Sandun. Now let’s hear your story.

Ok, have you ever had problems breathing?

And did your asthma problems get worse after that?

I understand, Sandun. Keep going. I am sure you have more to tell me

Hang in there son. I think you have got a condition called Obstructive Sleep Apnea or OSA for short.

Let me explain son. Obstructive sleep apnea is a sleep-related breathing disorder that involves a reduction or complete halt in the flow of air in your upper air passages. It occurs when the muscles relax during sleep, causing the muscle and tissue in the back of your throat to collapse and block your upper airway. This leads to partial reductions called hypopneas) and complete pauses called apneas in breathing that last at least 10 seconds during sleep. Most pauses last between 10 and 30 seconds, but some may persist for one minute or longer. This can lead to abrupt reductions in your blood oxygen levels, with oxygen levels falling as much as 40% or more in severe cases. When this happens your brain will respond to the lack of oxygen by alerting your body – this causes an arousal and you wake up abruptly. This pattern can occur hundreds of times in one night. As a result your sleep is fragmented, often causing you to be excessively tired in the day. Most people with OSA snore loudly and frequently, with periods of silence when airflow is reduced or blocked. They then make choking, snorting or gasping sounds when their airway reopens.

I know, Sandun. It can be quite a frightening experience.

Those who are overweight with a Body Mass Index of 25 to 29.9 or obese with a Body Mass Index of 30 and above are at risk of getting OSA. Men and women with large neck sizes: 17 inches collar size or more for men, 16 inches or more for women and people with short necks and facial features with a receding jaw line are also susceptible. Other include, adults and children with Down Syndrome and birth defects that give rise to abnormal facial structures, Children with large tonsils and adenoids, nasal congestion or blocks. People with certain hormonal disorders of thyroid or, pituitary gland and Smokers are also at risk.

I don’t mean to scare you son, but it can be serious because, OSA can result in fluctuating oxygen levels at night and an increased heart rate during arousals. This puts you at risk of developing disturbance in electrical activity of your heart. Other issues include a rise in daytime blood pressure, an increased risk of stroke, changes in blood sugar control and increased risk of diabetes, changes in concentration and mood changes and more which will affect your studies. Adults with OSA are at risk of being involved in a deadly motor vehicle accident as a result of falling asleep when driving.

I didn’t mean to scare you putha, I was just trying to give you all the facts.

You are a really smart boy, Sandun. But first, I need to have a chat with your mother and father. Then I will do a thorough examination when you come with them. I need to see why your asthma is not properly controlled I also need to see what problems you may be having with your sinuses and tonsils. And I need to check your blood pressure. I will also need to do some blood tests to check your blood sugar levels, cholesterol levels and thyroid hormone levels Finally, we need to do a Sleep Test or Polysomnography to diagnose OSA

You have a fine sense of humour son. Let me explain what a sleep test is. Sleep Apnoea must first be diagnosed at a sleep-lab during an overnight sleep study, or “polysomnogram.” The study will chart your vital signs, like your brain waves, heartbeat, breathing patterns, obstruction to airflow and blood oxygen levels.

CPAP or Continuous Positive Airway Pressure is the main way OSA is treated. CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open and prevents it from collapsing during sleep. It also prevents pauses in breathing and restoring normal oxygen levels. The newer CPAP models are small, light and virtually silent. You can choose from a number of mask sizes and styles to achieve a good fit.

I wish it like that too! But now, there is some work you have to do too. You need to lose weight, practice healthy eating and sleeping habits. You also need a doctor to sort out your sinus and tonsil problems.

Loosing that amount of weight is not simple, Putha. It takes a lot of effort, commitment and time. You need help to sort out your OSA while all that is happening.

No problem, I am glad to be of help. My son speaks very highly of you and I am glad he has you as a friend.

We all need each other, Putha; that is what friendship is all about.

No issue bro, that’s what friends are for.