Sleep Apnea: The Symptoms Indian Families Miss for Years
Obstructive sleep apnea affects an estimated 10-15% of middle-aged Indian men and is diagnosed in a small fraction of those. The condition breaks up sleep dozens of times an hour without the person realising, drives daytime fatigue and morning headaches, worsens BP and diabetes control, and raises the risk of heart attack and stroke over years. Most cases are noticed by a spouse before a doctor.
The symptoms family notices first
- Loud snoring with pauses, then a gasp.
- Restless sleep, frequent position changes.
- Waking to urinate multiple times a night.
- Morning headache.
- Daytime sleepiness — falling asleep during meetings, reading, watching TV.
- Difficulty concentrating.
- Uncontrolled BP or diabetes despite good adherence.
The STOP-BANG quick screen
Answer yes/no to each. Three or more suggests high risk and warrants investigation:
- S: T · Snore loudly (heard through closed door): Tired daytime
- S: O · Snore loudly (heard through closed door): Observed pauses in breathing
- S: P · Snore loudly (heard through closed door): Pressure — high BP or on BP medication
- S: B · Snore loudly (heard through closed door): BMI > 35
- S: A · Snore loudly (heard through closed door): Age > 50
- S: N · Snore loudly (heard through closed door): Neck circumference > 40 cm
- S: G · Snore loudly (heard through closed door): Gender — male
The diagnostic pathway
- Sleep physician consultation.
- Home sleep study (Level III/IV) — measures airflow, oxygen, heart rate overnight at home. ₹4000-8000.
- Polysomnography (Level I, in-lab) if home study is inconclusive or complex.
- Both produce an AHI (apnea-hypopnea index) — the number of breathing events per hour.
AHI interpretation
- AHI: < 5 · Severity: Normal · Typical action: No treatment
- AHI: 5-15 · Severity: Mild · Typical action: Lifestyle first; consider CPAP if symptomatic
- AHI: 15-30 · Severity: Moderate · Typical action: CPAP typically recommended
- AHI: > 30 · Severity: Severe · Typical action: CPAP strongly recommended
What to track once on treatment
- CPAP compliance hours per night (target > 4).
- Residual AHI on the device.
- Morning refreshment score (1-10).
- BP trend before and after CPAP start.
- HbA1c if diabetic — often improves within months.
A person who has struggled with unexplained BP or fatigue for years may see a step-change on effective CPAP treatment. The record with pre- and post-treatment numbers is what proves it worked, and what the sleep physician reviews at each annual visit.
References
Free for 90 days, no card needed. After that, keeping the record costs ₹349 for the year.
General information, not medical advice. Always talk to a qualified doctor about your own care. Where this and your doctor disagree, your doctor is right.