By Dr. Sanjeev Mohanty | ENT, Snoring & Sleep Apnea Specialist | Dr. Mohanty's Speciality ENT Clinics, Chennai
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Your spouse has
been nudging you awake for the past three years. You wake up exhausted despite
eight hours in bed. You've had two minor road accidents in the past year
because you felt drowsy at the wheel. Your doctor put you on blood pressure
medication last month.
You think these
are separate problems. They might not be.
Sleep apnea is one of the most underdiagnosed, underappreciated, and misunderstood conditions in ENT medicine. Millions of people in India are living with it right now — and the vast majority don't know it.
What is Sleep Apnea?
Sleep apnea is
a condition in which breathing repeatedly stops and starts during sleep. The
most common form — Obstructive Sleep Apnea (OSA) — occurs when the soft tissues
at the back of the throat collapse during sleep, temporarily blocking the
airway.
These pauses in breathing can last anywhere from 10 seconds to over a minute. They can happen dozens of times per hour — hundreds of times per night. Each time it happens, the brain sends an emergency signal to wake the body just enough to restart breathing. Most people are completely unaware this is happening.
Why Is This an ENT Problem?
This is the
question I get most often. People think sleep disorders belong to
pulmonologists or neurologists. And while those specialists certainly have a
role, the ENT surgeon is often the most important person in the management of
sleep apnea — because the problem, in the majority of cases, is structural.
The obstruction
is physical. It happens in the nose, the throat, the soft palate, the base of
the tongue, or some combination of these areas. These are all ENT territory.
At Dr. Mohanty's Speciality ENT Clinics, we have a dedicated Snoring & Sleep Apnoea Disorder Clinic because we see this every single day. It is not a rare condition. It is extraordinarily common — and extraordinarily consequential.
How Common Is Sleep Apnea in India?
Estimates
suggest that over 150 million adults in India may have some degree of
obstructive sleep apnea. The condition is particularly prevalent in people
who are overweight, have a thick neck, or have structural nasal issues like a
deviated septum. Interestingly, it is also more common in men than women,
though the gap narrows significantly after menopause.
The tragedy is how rarely it is diagnosed. Most patients come to us after years of suffering — exhausted, irritable, struggling at work, and often already dealing with the cardiovascular and metabolic consequences of the condition.
The Hidden Health Consequences — Why Sleep Apnea is a Medical Emergency in
Slow Motion
Sleep apnea is
not just about being tired. Each apnea episode — each pause in breathing —
causes a brief but significant drop in blood oxygen levels. The body responds
with a surge of stress hormones (adrenaline and cortisol). This happens dozens
of times every night, every night of the year.
The cumulative effect is devastating:
Cardiovascular
Disease
Untreated sleep apnea is one of the strongest independent risk factors for hypertension (high blood pressure). It is also strongly associated with atrial fibrillation, heart failure, and stroke. The repeated oxygen drops and stress hormone surges place enormous strain on the heart and blood vessels.
Diabetes
and Metabolic Syndrome
Sleep apnea disrupts insulin sensitivity and glucose metabolism. There is a well-documented bidirectional relationship between sleep apnea and Type 2 diabetes — each condition worsening the other.
Cognitive
Decline and Mental Health
Poor sleep quality has profound effects on memory, concentration, decision-making, and emotional regulation. People with untreated sleep apnea have significantly higher rates of depression, anxiety, and cognitive decline. There is emerging evidence linking severe sleep apnea with increased dementia risk.
Road
Traffic Accidents
This is the one that concerns me most as a clinician. Daytime sleepiness from sleep apnea is responsible for a staggering proportion of road accidents. Patients driving with untreated sleep apnea have reaction times equivalent to drunk driving. In a country like India with dense traffic, this is a public safety issue.
How Do You Know If You Have Sleep Apnea?
The classic
presentation includes several tell-tale signs. Ask yourself — or your partner:
•
Loud, disruptive snoring
(not just quiet snoring, but thunderous snoring)
•
Witnessed pauses in
breathing during sleep
•
Gasping or choking sounds
during sleep
•
Waking with a dry mouth,
headache, or sore throat
•
Excessive daytime
sleepiness despite adequate sleep time
•
Difficulty concentrating,
irritability, mood swings
•
Frequent night-time
urination (nocturia)
|
"I
always ask patients — do you feel refreshed when you wake up? If the answer
is no, and especially if there's snoring involved, sleep apnea is very much
on the differential. It's an underappreciated condition with overappreciated
consequences." — Dr. Sanjeev Mohanty |
Diagnosis — The Sleep Study
The gold
standard for diagnosing sleep apnea is a sleep study — called a
polysomnography. This records your brain waves, oxygen levels, heart rate,
breathing patterns, and leg movements throughout a night of sleep.
At our clinic, we work with accredited sleep labs that offer both in-lab and home sleep testing (portable sleep monitoring devices that a patient can use in the comfort of their own bedroom). We then review the results and develop a personalised management plan.
Treatment Options — There Is More Than CPAP
Most people who have heard of sleep apnea treatment think of CPAP — the machine with the mask that blows air continuously to keep the airway open. CPAP is effective. But it is not the only option, and it is not tolerated well by many patients.
Lifestyle
Modifications
Weight loss, sleeping on your side (not your back), avoiding alcohol before bed, and quitting smoking can all make a meaningful difference in mild-to-moderate sleep apnea.
Mandibular
Advancement Devices
These are custom-fitted oral appliances worn during sleep that gently advance the lower jaw, opening up the airway. They are a good option for patients with mild-to-moderate OSA who cannot tolerate CPAP.
ENT
Surgery
This is where I
come in directly. Depending on where the obstruction is located, surgical
options may include:
•
Septoplasty — correction of
a deviated nasal septum that contributes to obstruction
•
Turbinate reduction —
reducing enlarged nasal turbinates
•
Uvulopalatopharyngoplasty
(UPPP) — trimming excess soft palate and throat tissue
•
Tonsillectomy and
adenoidectomy — particularly effective in children with sleep apnea
•
Tongue base reduction
procedures
•
Hypoglossal nerve
stimulation (for eligible patients who don't tolerate CPAP)
Surgery is not the right answer for everyone. But for the right patient — particularly those with clear structural obstruction — it can be curative. I have had patients tell me that ENT surgery for their sleep apnea was the best decision they ever made.
Sleep Apnea in Children — Often Missed, Consequences Are Serious
This deserves
its own emphasis. Sleep apnea is not just an adult condition. It is common in
children — and frequently the cause is enlarged tonsils and adenoids.
Children with
untreated sleep apnea may present with behavioural problems, poor school
performance, bedwetting, and hyperactivity — symptoms that are often
misdiagnosed as ADHD. A simple tonsillectomy can, in many cases, completely
resolve the condition.
If your child snores loudly, breathes through their mouth habitually, or has restless sleep with bed-wetting, please bring them for an ENT evaluation. Do not dismiss it as 'just snoring'.
The 2026 Update — New Research and New Treatments
Sleep apnea
research in 2026 is exploding. The European ENT Surgery Conference in Rome
(September 2026) has listed sleep apnea management as one of its key focus
sessions. New research is examining the relationship between sleep apnea and hearing
loss — emerging data suggests that the chronic oxygen deprivation in
untreated OSA may contribute to inner ear damage.
Wearable sleep monitoring technology has improved dramatically — smartwatches and ring devices are now capable of detecting sleep apnea patterns with reasonable accuracy. While these are not diagnostic tools, they can prompt people to seek professional evaluation. That is a genuinely positive development.
A Personal Message from Dr. Sanjeev Mohanty
I have been
practising ENT medicine in Chennai for over 25 years. In that time, I have seen
sleep apnea wreck careers, relationships, and health. I have also seen the
transformation in patients who receive appropriate treatment.
The fatigue
lifts. The blood pressure improves. The irritability dissolves. Marriages
improve. Work performance recovers. People feel — sometimes for the first time
in years — what it is like to actually sleep.
This is not a minor quality-of-life issue. It is a major medical condition with life-altering consequences and life-improving solutions. If any part of this article resonated with you, please pick up the phone.
📞
Book at our Sleep Apnea Clinic: +91
97910 74677
📍 3, 234 Manapakkam Main Road, Manapakkam, Chennai – 600125
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