Singer Bappi Lahiri Passes Away Due To Obstructive Sleep Apnea: Causes, Symptoms And Treatment Of The Disorder

Veteran singer Bappi Lahiri passes away at 69 in Mumbai due to obstructive sleep apnea, a common sleep-related breathing disorder that causes breathing to repeatedly stop and start during sleep.

Our expert Dr Dillon Dsouza sheds light on the sleeping disorder. Dr Dsouza is a Mumbai-based Consultant ENT, Head and Neck surgeon, Snoring and Sleep Apnea, attached to Jaslok Hospital and Desa Hospital.

According to him, snoring is a condition where something in the nose, mouth, throat, or lungs blocks breathing while sleeping, producing a soft or loud and unpleasant sound. It is a sign or first alarm of OSA (obstructive sleep apnea).

Sleep apnea is where there are one or more pauses in breathing while you sleep. Pauses may last a few seconds to minutes, and as many as 30 times an hour. Breathing usually restarts with a loud snort or choking sound. Sleep apnea may be obstructive, central, or a combination called complex sleep apnea.

Another expert Dr Chandramohan, Senior ENT Surgeon, Kamineni Hospitals LB Nagar, Hyderabad talks about the sudden death of Bappi Lahiri due to Obstructive Sleep Apnea (OSA).

He said "OSA is a global disease with a rising incidence associated with comorbidities. Obesity has a strong correlation with OSA, and in obese people due to increased fat deposition in the throat, the upper airway narrowing shall occur along with decreased muscle activity which leads to multiple hypoxic and apneic episodes through the sleep".

"The decreased oxygenation ultimately is a contributory factor to hypertension and cardiovascular diseases. In India, the incidence of OSA is about 3-17%, with males affected more than females among an age group of around 30 -50 years. The most common risk factors include obesity, DM2, hypercholesterolemia, hypertension, depression".

"Luckily, we can treat OSA with surgical and non-surgical techniques which include weight reduction, reducing BP and anxiety and those who cannot be treated medically can be treated surgically. OSA is an important health crisis that demands multi-layered intervention which if diagnosed early can be treated, and can improve the overall health of the individual".

Causes

Snoring and obstructive sleep apnea: In the nose, a crooked nose bone or polyps are common causes; in the throat, throat muscle weakness, loose or tight jaw; fat in the neck; thick tongue; loose low roof of the mouth; or tongue falling back while sleeping on the back. Relaxants like alcohol or some medicines also cause this.

Effects

Medical: Increased risk of high blood pressure, heart attack, stroke, obesity, diabetes, heart failure, irregular heartbeats, and driving or work-related accidents.

Psychosocial: Irritability and poor concentration.

Social: Usually bed partner is also tired, irritable, and suffers sleep deprivation due to loud snoring. At one-time sleep apnea and snoring was major cause for divorces or separations around the world.

Signs And Symptoms

In adults, it includes loud chronic snoring almost every night; choking, snorting, or gasping during sleep; pauses in breathing; waking up often feeling out of breath; daytime sleepiness and tiredness; waking up with a dry mouth; going to the bathroom often at night; forgetfulness and decreased concentration; morning headaches; and impotence in men.

In children, loud snoring, sleeping in strange positions, bedwetting, heavy sweating at night, or night tremors are frequent symptoms.

Risk factors

Overweight, male, over 50, smoker, high blood pressure, alcoholic, or thick neck collar size over 40 cm. Crooked nose bones, large tonsils, flat chin, allergies and nasal polyps.

Treatment

Medical: All treatments for snoring and sleep apnea try to fix the blockage or bypass it. These include special pillows, devices to keep the jaw aligned or the nose open, and machines that continuously blow air into the nose and throat to keep them open (CPAP). These are all for mild to moderate cases.

Surgical: Uvulopalatopharyngoplasty (removal of tissues in the back of the throat), surgery to correct crooked nose bones and remove extra tissues from the nose, removal of tonsils, reducing the size of the tongue, and insertion of stiff materials into the top of the mouth.

Hyoid advancement where the bone in the neck to which tongue is attached is pulled up and forward, tongue advancement by moving the tip of the jaw outward, lower jaw advancement, where the entire upper and lower jaw is moved forward by 1.2cm, and making a hole in the neck called a permanent tracheostomy (for extreme cases).

What A Patient Can Do To Help Themselves/Self Help Tips:

Lose weight, exercise or brisk walking, lifestyle changes, mouthpieces, and use of breathing devices. Also, identification of other conditions causing obstruction like allergies and avoiding anything that causes allergies and blocked nose.

Quitting drinking, smoking, and avoiding taking sleeping pills or sedatives of any kind. Avoid caffeine and heavy meals two hours before sleeping. Yoga to strengthen the muscles of the throat.

Maintain regular sleeping hours. Sleeping on the side (or ask bed partner to roll you over if you snore), wedge a pillow stuffed with a tennis back behind the back to prevent rolling onto the back, elevate the head of the bed by 4 to 6 inches.

If the cause of sleep apnea is heart or nerve problems or any kind of brain damage or diabetes, get it treated by a specialist.

Get a sleep apnea test called polysomnography done.

Learning to play blowing instruments and singing can also strengthen throat muscles and reduce sleep apnea

Home exercises for sleep apnea include:

• Press the tongue down and brush the top and sides of the tongue with a toothbrush.
• Press the tongue up against the roof of the mouth and hold it there for 3 minutes a day.
• Purse the lips as if going to kiss and move them up and to the right, then up and to the left 10 times. Repeat again 3 times.
• Blow a balloon by breathing in through the nose and out through the mouth 5 times.
• Gargle with water for five minutes, twice a day.
• Lightly hold the tongue in teeth and swallow five times. Repeat this 5 to 10 times a day.