Dr Paulose

World Class ENT Plastic and Laser Surgeon

Snoring

Anesthesia, Coblator Surgery, CPAP, General, Health Tourism, Laser Treatment, Nose, Others, Sinusitis, Sleep, Sleep Apnoea, Snoring, Spirituality, Surgery, Throat, Tips ·

Testimonial of a Snoring and Sleep Apnea Sufferer.

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Over the years, I have treated thousands of patients suffering from snoring and sleep apnea. Many of them write me to tell how treatment has changed and improved their lives. Many of them were hooked on CPAP machine to live, but multilevel OSA Surgery have cured many of them and were able to give up CPAP Machine completely for good.

Please read the following Testimonial from one of my patient- Rev Fr.Shaji, who is a Christian preacher and priest from Bangalore India.

“A Whole New Life….”

My Testimony…

I am Rev Shaji Thomas who was suffering from severe Obstructive Sleep Apnea since 15 years.  After the sleep study I was advised to use CPAP Machine in 2011 but it was not at all successful for me. I was not able to travel in Train or in any other means with the public because of my unbearable snoring.  Day time sleepiness was my major problem. I felt very tired every day and was fully exhausted due to lack of oxygen supply to the brain. As a result of my OSA I was caught with BP and started medication since 2012 and other difficulties with my heart also occurred. I had to also start medication to control my cholesterol. One of ENT Specialist suggested undergoing a nasal surgery to remove the polyps in the sinus and also to rectify my deviated septum. For a second opinion I had an opportunity to visit Dr K O Paulose and after thorough check up and assessment including sleep study he advised me to to undergo CAUP (Coblator assisted Uvolopalatopharyngopasty. Coblator Tonsillectomy and Fess with Septoplasty and CAPT Turbinoplasty) . I was little worried about this surgery especially about my voice. Doctor guaranteed me for 80% result and I decided to undergo this multi level surgery on 7th June 2016 at Jubilee Memorial Hospital, Trivandrum. By God’s grace and by the committed treatment of Dr K O Paulose I am 100% alright after my surgery. Now my snoring has stopped and more energetic and fresh in all my activities-a whole new life now. The cost of Surgery was not too expensive also.

My heartfelt thanks to Dr K O Paulose and the staff of Jubilee Hospital which is a Christian Mission Hospital in Trivandrum, Capital of Gods Own Country Kerala in South India. All of them  became instrumental in my healing.

About the Surgeon-Doctor K O Paulose is more than a Doctor. He is good friend, counsellor, a family member, a man with compassion, a man of prayer and a person who is deeply committed to his Mission with no hidden agenda.

 

Rev Shaji Thomas

(A Priest of the Mar Thoma Syrian Church presently working at Bangalore)

Mobile – 09740812910

rev_shajiachan@yahoo.com

For Consultation:

http://drpaulose.com/consult

OR

Make Physical Consultation  with-

Dr.K.O.Paulose FRCS, Consultant ENT Surgeon

Jubilee Hospital Trivandrum Kerala South India

Tel. 0471 3080300 , 0471 233 4561

OP Clinic  Mon-Wed-Friday 9 AM -12 Noon

Operation Days Tues-Thu-Saturday 8 AM -2 PM

To Reach Jubilee Hospital: jubileehospitaltrivandrum

http://www.jubileehospital.org/

 

ENT For Pediatric (Children), General, Sleep Apnoea, Snoring ·

Does Your Child Snore and Stop Breathing while Sleeping?

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Snoring, stoppage of breathing during sleep, restless sleep and sleeping in strange positions are symptoms of sleep apnea in children. They also suffer from excessive daytime sleepiness and have attention problems and hyperactivity often with complaints from school.

If your child has these symptoms talk to your doctor. If you suspect your child may have sleep apnea, try videotaping him as he sleeps. Showing this video to your child’s doctor can help him or her make a diagnosis. Best way to make a diagnosis is to do a sleep study which these days can be done at your own home while the child sleeps.

The most common cause of sleep apnea in children is large adenoids and tonsils. (The adenoids are a mass of tissue that connects the back of the nasal cavity to the throat.) When the throat muscles relax during sleep the adenoids and tonsils can block the airway.

Treating snoring and sleep apnea in children

Those children who have sleep apnea from enlarged tonsils and adenoids can be helped by their removal. Some children have a dramatic positive change in personality, school work and health. Other kids with sleep apnea may be treated with positive airway pressure therapy, a special mask that keeps the airway open during sleep and/or assists breathing, but I wouldn\’t recommend it in an Indian scenario.

 

Sleep, Snoring, Tips, Treatment ·

Weight Gain or Weight Loss in CPAP Users?

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I have been treating snoring and sleep apnea patients for more than three decades. As a surgeon I try to do operate on these patients, but those who are unable to undergo surgery or unwilling for surgery I prescribe CPAP machine (Continuous Positive Airway Pressure).I must say CPAP is a wonderful machine having its advantages and disadvantages.

If you think that starting CPAP for obstructive sleep apnea would help you to lose weight, then read the recent study published in the Journal of Clinical Sleep Medicine find that this is not the case. In fact, using CPAP is found to cause statistically significant mild weight gain compared to sham CPAP users in this prospective randomized study.

After treating OSA patients over these years by CPAP therapy, I have heard many patients complaining of gaining weight and some say losing weight. Initially I thought patient who gets good sleep should lose weight and poor sleep should promote weight gain.

I read conflicting results on CPAP use and weight status. There are a number of possible reasons why this can happen, but no one is absolutely sure. Of course, I’ve also had many patients who did lose significant weight after CPAP, which only adds to my confusion.

So I thought write this article based on my experience, but I stress that more studies need to be done in this subject. Physicians should stress an active weight loss plan and not assume CPAP alone will lead to weight loss. A larger, prospective study may help clarify these findings.

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Obesity and Sleep Apnea

Obesity is causally linked to OSA. Why weight change after treatment with CPAP is not yet clear. Although hormonal changes would predict weight gain or loss, decreasing energy expenditure by reducing work of breathing would predict weight gain.

Metabolic Response in OSA

Sleep Apnea and Insulin Resistance

Obstructive sleep apnea (OSA) is characterized by sleep-related airway obstructions that produce apnea. These events provoke arousals and cause oxygen desaturations and heightened sympathetic activity during sleep and waking hours that may play a role in the development of insulin resistance. Obesity is a strong risk factor for OSA and both obesity and OSA are associated with increased insulin resistance and diabetes.

Obstructive sleep apnea (OSA) is associated with obesity, insulin resistance (IR) and diabetes. Continuous positive airway pressure (CPAP) rapidly mitigates OSA in obese subjects but its metabolic effects are not well recognized.

CPAP effectively improved hypoxia. However, subjects had increased insulin and IR. Fasting ghrelin decreased significantly while leptin, adiponectin and resistin remained unchanged. Changes in body weight directly correlated with changes in insulin and IR. Ghrelin changes inversely correlated with changes in IR but did not change as a function of weight.

Hormonal Changes

Hormones involved in the regulation of body weight and glucose metabolism include ghrelin, leptin, adiponectin and resistin. Ghrelin is an orexigenic hormone and it has been proposed as a cause of increased appetite and obesity .

Ghrelin is an appetite-increasing hormone postulated as a contributor to OSA-associated obesity as ghrelin levels were elevated .Leptin is secreted by adipocytes in proportion to body fat, being elevated in obese individuals and decreasing with weight loss. Adiponectin is decreased in obese individuals and in those with type 2 diabetes. It is thought to play a role in many of the metabolic complications suffered by these patients including metabolic syndrome and cardiovascular disease. However, its role in patients with OSA remains controversial.

CPAP treatment induced a decrease in fasting ghrelin levels, although body weight increased in most subjects. Adipokines such as leptin, adiponectin and resistin also appear to be influenced much more by adiposity rather than hypoxia. The fact that these adipokines remain unchanged after 6 months of CPAP treatment suggests that they are unlikely to play an important role in the development of the metabolic complications seen in the setting of OSA.

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CPAP and Body Weight

CPAP alone may not reduce body weight and that in the face of weight gain CPAP treatment may not reduce insulin resistance and leptin or increase adiponectin in obese subjects. It is possible that CPAP use has only a transient effect on insulin sensitivity and that changes in body weight are a much more important factor in the long-term regulation of insulin sensitivity.

Hypothyroidism and Sleep Apnea

Hypothyroidism is a condition where the body produces insufficient amounts of thyroid hormones, the most important of which is Thyroxine. Hypothyroidism produces many complications in the body including fatigue, loss of muscle tone, weight gain and sleep apnea, among others. It is thought that the symptoms of Hypothyroidism (swollen tongue and soft tissue in the mouth and throat) are responsible for the Sleep Apnea. As stated earlier, another frequent symptom of hypothyroidism is obesity, which can also cause sleep apnea.

This similarity in presenting symptoms raises a question on how patients with suspected OSA should be evaluated.

 Fluid retention may lead to pulmonary edema and cardiac failure

Complications of sleep apnea may lead to cardiac failure in some patients. Patients with hypertension are already at risk of developing cardiac failure and it is thought sleep apnea may increase the likelihood of this occurring. This in turn may result in gain in weight in some CPAP users.

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Conclusion

It’s all may be confusing to patients. I would recommend CPAP users must monitor their weight regularly and if there is substantial gain, then they should consult the physician. They also should start workout programmes to burn excess calories they saved overnight by decreased energy expenditure during work of breathing which is taken over by CPAP machine.