Can you think of a soldier falling asleep on the war frontline and airline pilot nodding off while flying? Can you think of your driver doze of while driving? Can you think of your security man sleeping on duty in your house or apartment?
Not so serious, in the new age of hi-tech jobs like IT industry, falling asleep while on duty is a serious matter of concern.
Day time sleepiness is very common in patients who snore loudly and suffer from obstructive sleep apnea.
Sleeping on the job refers to falling asleep while on the job. In some workplaces, this is considered gross misconduct and may be grounds for disciplinary action, including possible termination of employment. While some employees who sleep while on duty in violation do so intentionally and hope not to get caught, others intend in good faith to stay awake, and accidentally doze off.
Concerns that employers have may include the lack of productivity, the unprofessional appearance, and danger that may occur when the employee’s duties involve watching to prevent a hazardous situation.
Some companies have instituted policies to allow employees to take napping breaks during the workday in order to improve productivity, while others are strict when dealing with employees who sleep while on duty and use high-tech means, such as video surveillance, to catch their employees who may be sleeping on the job. Those who are caught in violation may face disciplinary action such as termination from their job.
About snoring and sleep apnea-Read on-
Snoring is the sound produced by upper airway passage obstruction-Nose-and throat. Vibration of the elongated soft palate and uvula makes the noise.
Sleep Apnea is present when we do not breathe for 10 seconds or longer. This is dangerous. This causes our blood oxygen levels to drop and the carbon dioxide level gets more. This put pressure on the cardiovascular system mainly the heart work more to cope up supplying enough oxygen to brain and other tissues.
This apnea can happen a few times per night or several hundred times per night resulting in no deep sleep and many health problems.
There are two types of sleep apnea: central and obstructive. Central sleep apnea is much less common and is a problem in the regulatory function of the brain or heart. This occurs most frequently in people who have chronic congestive heart failure (COPD), stroke, and prolonged drug users.
Obstructive Sleep Apnea is more common and is caused by the physical blockage of the airway at night by the tissue in the back of the throat collapsing to block the airway. This keep oxygen from getting to the lungs as the muscles and thus tissue relax in the throat as you sleep combined with the force of gravity causing the tongue to fall back and block the airway when you lay down. More so in obese patients who has lot of fat deposition in the neck.
Snoring can be serious both medically and socially. Snoring can disrupt marriages and cause sleepless nights for bed partners.
Medically snoring can be a precursor of obstructive sleep apnea that has been linked to heart failure, high blood pressure and stroke.
Often people with large necks, overweight and large uvula and soft palate or nasal congestion or all of the above can be more likely to die in their sleep as their heart disease advances since the heart is already compromised.( Silent death while at sleep) These are people who you hear of having a heart attack in their sleep.
People with untreated Obstructive Sleep Apnea suffer from daytime fatigue, sleepiness and irritability. Additionally they have higher rates of high blood pressure, heart disease, stroke, depression and erectile dysfunction. Often people with severe untreated sleep apnea will fall asleep at a stop light or dose off (micro sleep) for a moment while driving, sometimes causing them to swerve or lose control of their car causing Road traffic accidents.
The daytime fatigue associated with the lack of quality sleep can affect your job performance, memory loss, affect your ability to concentrate make you irritable and affect your relationships. These affect more in people who should be more alert in their jobs, like pilots, IT professionals, Golfers etc.
See the ENT doctor if you have the following signs-
and Snoring interrupted by a pause in breathing and then gasping (sudden intake of air)
and Daytime Fatigue and ay time sleepiness
and Loud Snoring
and Trouble with concentrating, poor memory, depression, irritability, or loss of sex drive
and Headaches, frequent nighttime urination, dry mouth, sore throat.
Diagnosis
1- Good history from the spouse. Some bed partners come with voice recording of their spouse snoring.
2- Full ENT examination including fibre optic flexible naso pharyngo laryngoscopy in the clinic
3- MRI or CT scan to see the site of obstruction
4- Sleep lab study-Polysomnogram
5- Cardiac check up
6- .Preanasethetic check up
Treatment
1. Weight reduction
2. Stop taking alcohol, sedatives, sleeping pills
3. Treatment for nasal allergy, High BP, Diabetes etc if associated with it.
4. CPAP-can be tried, but most patients not happy to use it, cumbersome and expensive.
5. Surgical treatment-Laser or Coblator surgery
6. (please check-search this site for articles on different modalities of surgical treatment)
For more help-
http://suthospital.com/php/list_department.php?dept_id=15&linkid=3
http://www.suthospital.com/php/seek_appt.php
http://suthospital.com/php/list_department.php?linkid=3&dept_id=15&type=F
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