Sleep Apnoea is a sleep disorder in which breathing repeatedly stops and starts. We may have sleep apnea if we snore loudly and feel tired even after a full night's sleep.

There are three types of Sleep apnea:

• Obstructive sleep apnea: this type occurs when throat muscles relax
• Central sleep apnea: this type occurs when your brain doesn't send proper signals to the muscles that control breathing
• Complex sleep apnea: in this type both the above mechanism play a role

Obstructive sleep apnea occurs when the muscles in the back of throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate known as uvula, the tonsils and the tongue. The muscles relax, the airway narrows or closes as we breathe in, and breathing stops for some time. This may lower the level of oxygen in blood. Our brain senses this inability to breathe and briefly rouses us from sleep so that we can reopen airway. This awakening is usually so brief that we don't remember it. We can awaken with a transient shortness of breath that corrects itself quickly, within one or two deep breaths, although it is rare. We may make a snorting, choking or gasping sound. This pattern can repeat itself 10 to 40 times or more in an hour, during the whole night. These disturbances decrease the levels of necessary deep sleep, restful phases of sleep. Because of this there is sleepy feeling during day time. People may not be aware that their sleep is interrupted. In fact, many people with this type of sleep apnea think they sleep well during night. Central sleep apnea, which is far less common, occurs when the brain fails to transmit signals to breathing muscles. Person may awaken with shortness of breath or have a difficult time staying asleep. Like obstructive sleep apnea, snoring and daytime sleepiness can occur. The most common cause of central sleep apnea is heart disease, and stroke. People with central sleep apnea may be more likely to remember awakening than people with obstructive sleep apnea are.

People with complex sleep apnea have upper airway obstruction just like those with obstructive sleep apnea, but they also have a problem with the rhythm of breathing and occasional lapses of breathing effort.

The most common signs and symptoms of obstructive and central sleep apneas:

• Excessive daytime sleepiness
• Loud snoring, which is usually more prominent in obstructive sleep apnea
• Observed episodes of breathing cessation during sleep
• Abrupt awakenings accompanied by shortness of breath, which more likely indicates central sleep apnea
• Awakening with a dry mouth or sore throat
• Morning headache
• Difficulty staying asleep

Following are the leading signs to rule out sleep apnea:

• Snoring loud enough to disturb the sleep of others or yourself
• Shortness of breath that awakens you from sleep
• Intermittent pauses in your breathing during sleep
• Excessive daytime drowsiness, which may cause you to fall asleep while you're working, watching television or even driving

Following factors may be considered as risk factors for sleep apnea:

• Excess weight.
• Neck circumference: A neck circumference greater than 17.5 inches is associated with an increased risk of obstructive sleep apnea.
• High blood pressure: people with hypertension may suffer from sleep apnea
• A narrowed airway: this may be a congenital defect
• Being male: Sleep apnea is more common in male than female.
• Being older: Sleep apnea is more common in elderly age group
• Family history: Positive family history is an additional risk factor
• Heart disorders and stroke or brain tumor: these are related to central sleep apnea

Complications may include:

• Cardiovascular problems: The more severe your sleep apnea, the greater the risk of high blood pressure. If there's underlying heart disease, these multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from a cardiac event. Obstructive sleep apnea also increases the risk of stroke, regardless of whether you have high blood pressure
• Daytime fatigue: severe daytime drowsiness, fatigue and irritability is experienced. Concentration difficulty. Falling asleep at work, while watching TV or even when driving. Irritability, moodiness and depression
• Sleep-deprivation of others: Loud snoring can disturb sleep of those around you or those who share same room or bed with you
• Mental state: sleep apnea may also complain of memory problems, mood swings or feelings of depression
• Urinary and sexual function: a need to get up for urination frequently at night, and impotence
• Gastrointestinal problems: Gastroesophageal reflux disease (GERD) may be more common in people with sleep apnea

Role of Homeopathy in Sleep Apnea:
Homeopathy reduces the symptom severity of sleep apnea in cases where the illness is not due to some structural obstructions of airway. Homeopathy also helps in reducing the complications of sleep apnea. Homeopathy is safe and effective without causing any side effects. Homeopathy also helps in treating the underlying cause of sleep apn Ankylosing Spondylitis is a form of chronic inflammation of the spine and the sacroiliac (SI) joints. The SI joints are located in the low back at the junction of spine and hip. Chronic inflammation in these areas causes pain and stiffness in and around the spine. Over the period of time, chronic spinal inflammation (spondylitis) can lead to a complete cementing together (fusion) of the vertebrae, a process referred to as ankylosis. Ankylosis leads to loss of mobility of the spine. Ankylosing spondylitis is also a systemic rheumatic disease, meaning it can affect other tissues throughout the body. Accordingly, it can cause inflammation in or injury to other joints away from the spine, as well as other organs, such as the eyes, heart, lungs, and kidneys. Ankylosing spondylitis shares many features with several other arthritis conditions, such as Psoriatic Arthritis, Reactive Arthritis, and arthritis associated With Crohn's Disease and Ulcerative Colitis. Each of these arthritic conditions can cause disease and inflammation in the spine, other joints, eyes, skin, mouth, and various organs. In view of their similarities and tendency to cause inflammation of the spine, these conditions are collectively referred to as "Spondyloarthropathies." The tendency to develop ankylosing spondylitis is believed to be genetically inherited, and the majority (nearly 90%) of patients with ankylosing spondylitis is born with the HLA-B27 gene. Blood tests help to detect the HLA-B27 gene marker. The characteristics of the gene marker HLA-B27 are being further understood. There are now seven different subtypes of HLA-B27 known to be present.

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 Dr Harshad Raval MD [Homeopathy]
Honorary consultant homeopathy physician to his Excellency Govern.of Gujarat India.
Qualified MD consultant homeopath Physician,
Member of nominee advisory committee (Govt. of Gujarat).
International Homeopathy Advisor, Book writer and Columnist For Gujarat Samachar,   ADDRESS:16,floor,white-House| Ellishbridge | Ahmedabad | Gujarat | India
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