2. MÜKAM KARÔTI VACÁLAM
PANGUM LANGHAYATÄ
GIRIM
YATKRIPÁ TAMAHAM VANDÄ
PARAMÁNANDA SÁGARAM
PRAYER

3. Name of the disease & terminologies
Etiology
History, signs and symptoms
Physical examination
Investigation
Treatment according to allopathic medicine
Other therapies
Yoga practices
Books and journals for reference

4. INTRODUCTION
 Central and/or peripheral apnea during sleep,
associated with frequent awakening and often
with daytime sleepiness.
 Been told that patient snore loudly?
 Waking up feeling tired after a full night's
sleep?
 Sleepy during the day?
 In this potentially serious sleep disorder,
breathing repeatedly stops and starts during
sleep.

5.  "Apnea" in Greek "without breath."
 Sleep apnea occurs in two main types:
obstructive sleep apnea, the more common
form that occurs when throat muscles relax,
and central sleep apnea, which occurs when
brain doesn't send proper signals to the
muscles that control breathing.
 Additionally, some people have complex sleep
apnea, which is a combination of both
obstructive and central sleep apneas.

6.  Obstructive sleep apnea occurs two to three
times more often in older adults and is twice
as common in men as in women.
 Treatments for sleep apnea may involve using
a device to the keep airway open or
undergoing a procedure to remove tissue from
nose, mouth or throat.

8. SIGNS AND SYMPTOMS
 The signs and symptoms of obstructive and
central sleep apneas overlap, sometimes
making the type of sleep apnea more difficult
to determine.
 The most common signs and symptoms of
obstructive and central sleep apneas include:
 Excessive daytime sleepiness (hypersomnia)
 Loud snoring
 Observed episodes of breathing cessation
during sleep

9.  Abrupt awakenings accompanied by shortness
of breath
 Awakening with a dry mouth or sore throat
 Morning headache
 Difficulty staying asleep (insomnia)
 Disruptive snoring may be a more prominent
characteristic of obstructive sleep apnea, while
awakening with shortness of breath may be
more common with central sleep apnea.

10. CAUSES
 Obstructive sleep apnea occurs when the
muscles in the back of the throat relax.
 These muscles support the soft palate, the
triangular piece of tissue hanging from the soft
palate (uvula), tonsils and tongue.
 When the muscles relax, airway narrows or
closes during the respiration and breathing
momentarily cuts off.
 This may lower the level of oxygen in the
blood.

11.  The brain senses this inability to breathe and briefly
rouses patient from sleep so that patient can reopen the
airway.
 This awakening is usually so brief that patient does not
remember it.
 Patient awaken with a transient shortness of breath that
corrects itself quickly, within one or two deep breaths,
although this is rare.
 Snorting, choking or gasping sound is heard.
 This pattern can repeat itself 20 to 30 times or more
each hour, all night long.
 These disruptions impair the ability to reach those
desired deep, restful phases of sleep, and feel sleepy
during waking hours.

12.  People with obstructive sleep apnea may not be
aware that their sleep was interrupted.
 In fact, many people with this type of sleep apnea
think they sleep well all night.
 Central sleep apnea, which is far less common, occurs
when brain fails to transmit signals to breathing
muscles.
 Patient may awaken with shortness of breath or
headaches.
 The most common cause of central sleep apnea is
heart disease.
 People with central sleep apnea may be more likely to
remember awakening than people with obstructive
sleep apnea are.

13. RISK FACTORS
 Sleep apnea may occur – young or old, male
or female.
 Even children can have sleep apnea, but
certain factors increases the risk:
 Central sleep apnea
o Sex. Males are more likely to develop
central sleep apnea than are females.
o Heart disorders.
o Stroke or brain tumor.
o Neuromuscular disorders.
o High altitude.

14.  Obstructive sleep apnea
o Excess weight.
o Neck circumference.
o High blood pressure (hypertension).
o A narrowed airway.
o A family history of sleep apnea.
o Use of alcohol, sedatives or tranquilizers.
o Smoking.

15. Obstructive sleep apnea occurs when the muscles that support the
soft tissues in the throat, such as tongue and soft palate, relax.
When these muscles relax, the airway is narrowed or closed, and
breathing is momentarily cut off.

16. WHEN TO SEEK MEDICAL ADVICE
 Snoring loud enough to disturb the sleep of
others
 Shortness of breath that awakens patient from
sleep
 Intermittent pauses in patient breathing during
sleep
 Excessive daytime drowsiness, which may
cause patient to fall asleep while working,
watching television or driving

17.  Many people don't think of snoring as a sign
of something potentially serious, and not
everyone who has sleep apnea snores.
 With sleep apnea, snoring typically is loudest
when patient sleep on the back, and it quiets
when patient turn on one side.
 Patient is chronically fatigued, sleepy and
irritable.
 Excessive daytime drowsiness (hypersomnia)
may be due to other disorders, such as
narcolepsy.

18. SCREENING & DIAGNOSIS
 Sleep specialist for further evaluation.
 Such an evaluation often involves overnight
monitoring of breathing and other body
functions during sleep.
 Tests to detect sleep apnea include:
 Nocturnal polysomnography.
 Oximetry.
 Portable cardiorespiratory testing.

19.  Obstructive sleep apnea patient needs
(otolaryngologists) to rule out any blockage in
the nose or throat.
 An evaluation by the cardiologist or
neurologist may be necessary to look for
causes of central sleep apnea.

20. COMPLICATIONS
 Sleep apnea is a serious medical condition.
 Complications may include:
Cardiovascular problems.
Daytime fatigue.
Complications with medications and
surgery.
Sleep-deprived partners.

21.  People with obstructive and central sleep
apneas may also complain of memory
problems, morning headaches, mood swings
or feelings of depression, a need to urinate
frequently at night (nocturia), and impotence.
 Gastroesophageal reflux disease (GERD) may
be more prevalent in people with sleep apnea.
 Children with untreated sleep apnea may be
hyperactive and may be diagnosed with
attention-deficit/hyperactivity disorder.

22. TREATMENT
 For milder cases of sleep apnea, lifestyle
changes such as losing weight or quitting
smoking is useful.
 Certain devices can help open up a blocked
airway. In other cases, surgery may be
necessary.

23. Treatments for obstructive sleep apnea may
include:
Therapies
 Continuous positive airway pressure (CPAP).
 Oral appliances. Another option is wearing an
oral appliance designed to keep throat open.
CPAP is more effective than oral appliances,
but oral appliances may be easier to use. Some
are designed to open the throat by bringing
jaw forward, which can sometimes relieve
snoring and mild obstructive sleep apnea.

24. For moderate-to-severe sleep apnea, doctor may recommend a
common therapy device called a nasal continuous positive airway
pressure (CPAP) machine. A CPAP machine delivers just enough
air pressure to keep the upper airway passage open, preventing
apnea and snoring.

25. Surgery or other procedures
 The goal of surgery for sleep apnea is to
remove excess tissue from nose or throat that
may be vibrating and causing snoring, or that
may be blocking upper air passages and
causing sleep apnea. Surgical options include:
 Uvulopalatopharyngoplasty (UPPP).
 Maxillomandibular advancement.
 Tracheostomy.

26. Other types of surgery may help reduce snoring
and sleep apnea by clearing or enlarging air
passages:
 Nasal surgery to remove polyps or straighten a
crooked partition between nostrils (deviated
nasal septum)
 Surgery to remove enlarged tonsils or
adenoids

27. Treatments for central sleep apnea are more
limited and include:
 Treatment for associated medical problems.
 Supplemental oxygen.
 Continuous positive airway pressure.
 Bilevel positive airway pressure (bilevel
PAP).
 Adaptive servo-ventilation (ASV).

28. SELF-CARE
 In many cases, self-care may be most
appropriate way to deal with obstructive sleep
apnea and possibly central sleep apnea.
Try these tips:
 Lose excess weight.
 Avoid alcohol and medications such as
tranquilizers and sleeping pills.
 Sleep on one side or abdomen rather than on
the back.
 Keep the nasal passages open at night.

29. YOGA PRACTICES
YOGA IS BALANCE (SAMATVAM)
I A Y T CORRECTS IMBALANCES
AIMS :
• STRESS REDUCTION
• RELIEF OF PAIN
• MEDICATION REDUCTION

30. INTEGRATED YOGA MODULE FOR
SLEEP APNEA
Breathing practices
 Hands stretch breathing
 Dog breathing
 Tiger breathing
 Tongue massaging
 Tongue in and out
 Tongue rotation
 Bhramari
 Lip stretch
 Karna sakti vikasaka
 Mukha dhouti
 Laughter
 Mouth twisting
 Tongue twisting
 Head rolling
 Vaksakti vikasaka

31. Yogasanas
 Ardhakati cakrasana
 Ardha cakrasana
 Padahastasana
 Bhujangasana
 Salabhasana
 Viparita karani
 Sarvangasana
 Halasana
 Matsyasana
 Deep relaxation technique (DRT)

32. Pranayama
 Kapalabhati
 Vibhaga pranayama
 Nadi suddhi
 Ujjyi pranayama
 Bhastrika pranayama
 Bhramara / Bhramari pranayama
 Chanting (Maha mrityunjaya mantra, songs & bhajans)
 Simha Mudra
Meditation (Dhyana & Dharana)
 Nadanusandhana
 OM meditation
Kriyas
Jala Neti
Sutra Neti
Vaman Dhouti

33. SPECIFIC PRACTICES
 Pranayama
 Static Jogging
 Jalaneti
 Supta Vajrasana
 Chakrasana