A comprehensive study of clinical and psychological factors in snoring and obstructive sleep apnoea.

Balakrishnan, D (2008) A comprehensive study of clinical and psychological factors in snoring and obstructive sleep apnoea. Doctoral thesis, Madras Medical College, Chennai.

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Abstract

In recent decades, awareness of sleep apnoea syndromes has increased both in the public mind and among medical professionals. As a result, more patients demand treatment of sleep disorders. However, the health care delivery system is unable to meet this demand. The inadequacies mainly relate to lack of infra structure and lack of skilled manpower. When great advances have been made in the medical field, provision of such facilities may appear to be simple. But, we are hampered by lack of information regarding the size of the problem. We do not know the actual prevalence of sleep disordered breathing. Another significant inadequacy relates to the absence of a comprehensive algorithm for approaching a patient with suspect OSA. The skill sets required for this algorithm are spread widely amongst various specialists, namely pulmonologists, neurologists, critical care specialists, internal medicine specialists and otolaryngologists. Supporting staff in the pulmonary, sleep and imaging laboratories must be developed. The willingness of the health insurance to assume the reimbursement of expenses will play an important role in this development. This study is an effort in meeting the first of these inadequacies namely, defining the magnitude of the burden of this disease. Sleep is a state of unconsciousness, from which a person can be aroused, albeit with some difficulty. It is a complex neurological state, with its primary function of providing rest and restoring the body’s energy levels. The importance of sleep could be seen from the fact that people spend about one-third of their lifespan in sleep. It is essential for life; it is difficult to enumerate its functions. It is stated that sleep is essential for restoration and recovery. Energy conservation is one function that is proposed for sleep. Sleep may help to discharge emotions through dreaming. Memory consolidation, brain growth and repair are the other functions proposed for sleep. Restorative functions including immunity build up are also attributed to sleep. The aims of this study are three fold: 1. To study the prevalence of snoring and sleep apnoea in the general population. 2. Comparison of clinical and psychological profiles of children suffering from snoring and sleep apnoea with non-obstructed children 3. Study of the changes in the above profiles, after therapeutic intervention i.e. adeno tonsillectomy. The entire study was done in two parts Part I. Study of the prevalence of snoring Part II. Interventional study of children with adeno tonsillar enlargement, before and after surgical therapy. Summary: In a first attempt to gather data about the prevalence of snoring in this part of the world, a questionnaire survey was conducted in Chennai, India. The survey sample of 1075 consisted of various age groups. The over all prevalence of snoring was 19.5%. Across the age groups, the male gender and affluence had a positive association with snoring. The BMI increased the snoring prevalence only in the adults. A history of sore throat was positively associated with snoring significantly in the children less than 12 years of age only. This survey broadly indicates the profile of snorers in this part of the world. The lack of concern among a fifth of the snorers was noted in this study. Limitations of this study: This study has all the limitations of a questionnaire survey. While a positive association had been noted between sore throat and snoring, no further attempt at defining the nature of snoring (primary or secondary) was attempted in this phase 1 of the study.

Item Type: Thesis (Doctoral)
Uncontrolled Keywords: snoring; obstructive sleep apnoea
Subjects: MEDICAL > Ent
Depositing User: Devi S
Date Deposited: 20 Jun 2017 06:43
Last Modified: 20 Jun 2017 09:54
URI: http://repository-tnmgrmu.ac.in/id/eprint/124

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