Obstructive sleep apnoea in 31-year-old female patient!

[Patralekha]

A 31-year-old female friend of mine presented to various institutions with complaints of exertional dyspnea, wheezing, and nocturnal cough for three years. Her complaints did not improve although she used inhaler corticosteroids, beta-mimetic inhaler devices, oral montelukast and theophylline with the diagnosis of asthma. The physical examination showed that the patient was 160 cm tall and had a body weight of 60 kg and a body mass index of 23.4 kg/m2; arterial blood pressure was 120/75 mmHg, pulse was 95 bpm, respiratory rate was 25/min, and she had tachypnea. On respiratory system examination, there were inspiratory rhonchi in all lung fields. Other system examinations were normal. Laboratory examinations were normal except for a mild anemia (Hb 11.2 gr). Chest X-Ray, respiratory function tests, bronchoscopic tests, and transthoracic echocardiography of the patient revealed normal results. The patient was considered to have an upper airway obstruction. Computed tomography (CT) of the thorax and paranasal sinuses and magnetic resonance imaging (MRI) of the neck, which were obtained to reveal this, were normal. On ear-nose-throat and laryngoscopy examinations, the upper airway was normal. The patient was evaluated by the gastroenterology department and confirmed not to have gastroesophageal reflux by abnormal 24-hour esophageal pH study. Please suggest how to treat this obstructive sleep apnoea.

[Bithika]

@patralekha For milder cases of obstructive sleep apnea, your doctor might recommend lifestyle changes:
Lose weight if you're overweight.
Exercise regularly.
Drink alcohol moderately, if at all. Don't drink in the hours before bedtime.
Quit smoking.
Use a nasal decongestant or allergy medications.
Don't sleep on your back.
Avoid taking sedative medications such as anti-anxiety drugs or sleeping pills.
If these measures don't improve your sleep or if your apnea is moderate to severe, then your doctor may recommend other treatments. Certain devices can help open up a blocked airway. In other cases, surgery may be necessary.
Positive airway pressure. If you have obstructive sleep apnea, you may benefit from positive airway pressure. In this treatment, a machine delivers air pressure through a piece that fits into your nose or is placed over your nose and mouth while you sleep.
Positive airway pressure reduces the number of respiratory events that occur as you sleep, reduces daytime sleepiness and improves your quality of life.