While Obstructive Sleep Apnea (OSA) is more commonly seen in men, where they experience symptoms like snoring, the condition often goes underdiagnosed in women. In a study published in the Medical Principles and Practice journal, it has been seen that OSA has traditionally been assumed to be a male health condition with a stereotype of an overweight, snoring, middle-aged sleepy man. This has led to delays in identification and even a lack of diagnosis of the condition in women. One such case that I encountered was of Shilpi Singh, a 65-year-old woman from Patna in Bihar who was dealing with a sleep disorder that went undiagnosed, leading to health complications.
Diagnosed with acute respiratory failure
One evening, this 65-year-old patient experienced symptoms like cough and fever. However, it was not a simple fever and her condition deteriorated gradually, reaching a point where she became hypoxic (a condition where the body lacks sufficient oxygen). Rushing her to the hospital was the only option left for the family.
She was immediately admitted and her treatment started. But overnight, her oxygen levels decreased and she landed up with acute respiratory failure to the extent that she was not even responding to treatments and had to be finally put on a ventilator.
This was unusual because she had no history of diabetes or other comorbidities like asthma. She turned out to be flu positive. Shilpi was overweight and on enquiring with the family members, we came to know that she was not doing any physical activities and also experienced excessive daytime sleepiness, which affected her overall quality of life.
Sleep study shows severe obstructive sleep apnea
Once there was a gradual improvement in her health and she was out of the ventilator, she was discharged from the hospital. However, she was still put on oxygen support at home. Observing her symptoms such as excess weight, daytime sleepiness and a history of snoring, we decided to conduct a polysomnography. The results revealed that Shilpi had severe obstructive sleep apnea.
Prior to her diagnosis, Shilpi reported feeling very tired and found it difficult even to take a few steps. Despite consulting many experts in her hometown, there was no improvement. This is when her daughter brought her to Manipal Hospital in Bangalore, where we identified her OSA.
Sleep problems and health improved with CPAP machine
Shilpi was immediately put on a Continuous Positive Airway Pressure (CPAP) therapy machine and within three months, her health improved significantly. She started feeling active and began practicing exercises. Though she weighed 96 kgs earlier, she has reduced almost five kilograms since starting her exercise routine.
Initially, Shilpi felt uncomfortable while wearing the CPAP machine while sleeping because it was difficult to turn. However, with time, she adapted to it and her sleep improved significantly, reducing her frequent nighttime awakenings.
While talking or performing daily tasks, Shilpi would doze off. Since snoring does not bother the patient but rather the partner, she never thought of getting a sleep test done until she faced acute respiratory failure.
But now, with weight loss, improved physical activity and regular CPAP use, Shilpi’s quality of life has significantly improved.
Source: https://www.happiesthealth.com/discussions/sleep/old-woman-with-serve-obstructive-sleep-apnea
