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Decoding sleep disorder, a nap at a time

Sleep apnea is caused when oxygen supply is blocked during sleep, leading to frequent episodes of waking up

Written by Tabassum Barnagarwala | Mumbai | Published: June 4, 2017 1:29:10 am

As dusk touched the Mumbai horizon and office-goers scurried for a Friday night do, in a quaint Vile Parle East lane, 62-year-old Ashutosh Chhaya hailed an auto rickshaw with wife Purnima, to spend the night at Dr R N Cooper Hospital.

Wearing dark brown trousers and a light brown shirt, the retired banker has been suffering from a sleep disorder for ten years now. On Friday night, he hoped to get a detailed study on the disorder, as he slept on a cozy bed in an air-conditioned room on the hospital’s sixth floor with a series of tubes and sensors on his chest and nose. The room is called the ‘sleep apnea laboratory’.

By 8 pm, he finished his dinner in the ENT male ward, and waited for the doctor. There were four other patients. A cool breeze floated through the large, grilled windows bringing in the fragrance of moist earth. “It may rain,” he hoped, before discussing his long battle with sleep disorder.

A mobile phone with his favourite playlist of Lata Mangeshkar’s songs would keep him company in the lab.

“In 2007, I underwent angioplasty and doctors diagnosed sleep apnea. I used CPAP (Continuous positive airway pressure) machine for two days but didn’t want to continue with it,” said the sexagenarian.

Sleep apnea is caused when oxygen supply is blocked during sleep, leading to frequent episodes of waking up. The disturbed sleep during night forces a person to nap during the day and snore sometimes. Laughing, Purnima said, “He snores when he is really tired. But I am used to it. I can sleep through it.”

Chhaya sometimes does not get sleep until 4 am. He watches television or listens to music until sleep catches up. “I am worried. Doctors say my diabetes and heart ailment is aggravated by apnea. Don’t you hear cases when people get heart attacks in sleep?,” he asked.

The couple has no children. Their life after retirement is run by their collective savings. Private hospitals charge Rs 11,000-17,000 to study sleep patterns. So, Chhaya delayed his treatment, tried yoga and daily walks to stay fit. A month ago, he read about the BMC-run sleep apnea centre. “They will not charge a single rupee to study my sleep pattern. Can you believe it?,” he asked, smiling.

He had registered himself for a night at the Cooper Hospital. The waiting period is ten days. The sleep apnea laboratory, which had started in the suburban hospital two months ago, had tested about 50 patients so far. A new patient sleeps in the the laboratory every night.

On Friday, the couple let go of their evening walk to reach the hospital. Purnima (60) leaves shortly after 9 pm. A doctor comes, first notes down Chhaya’s history and asks him how long has he suffered from sleep disorder, whether he snores, or if he feels sleepy during the day.

“Then we prepare the polysomnography machine and fix it to his chest,” said Dr Labdhy Nirmal, ENT specialist. A tube is attached to his nose to record his breathing and snoring episodes. Another pulse probe is attached to his finger for pulse rate. Through the night, polysomnogram records the fluctuation in the pulse rate, oxygen saturation, respiratory rate, episodes of waking up, and snoring.

Chhaya is apprehensive. “I don’t get sleep easily in new places,” he said. He takes out his phone, relying on Lataji’s songs to make him sleep.

According to nurse Sheetal Raut, the machine will be removed by 8 am and will be attached to a computer to show various graphs detailing his sleep. “But he can turn and twist in his sleep,” she added.

Doctors will study his sleeping pattern, to see if he has apnea of hyopnea. Hyopnea is when breathing is shallow and apnea is more intense when breathing completely stops during sleep. Chhaya had questions about whether he can visit the bathroom during the night or when can he have breakfast. “With this treatment ,if he stops snoring, I’ll be happy,” said Purnima.

“Usually, surgery treats apnea, but medications also help,” said Dr Shashikant Mhashal, head of ENT department at Cooper Hospital.

As Chhaya prepares to enter the sleep apnea laboratory — a tiny room with a cot and a table, with two walls full of charts and diagrams. “Teenagers stay up late at night. They don’t realise the importance of good sleep. This awareness comes at our age,” he said.

It is 10 pm, his usual time to go to bed. Chhaya lied down on the cot and hoped that sleep will not elude him for too long and by morning doctors would know why it has been playing hard to get.

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