Dr. Arup Haldar, Consultant Pulmonologist at CK Birla Hospitals, CMRI, Kolkata
Obesity is often associated with obstructive sleep apnea or OSA. Extra body fat is a key risk factor. Still, it is a mistake to think OSA only happens when someone is heavy. Many people who have a normal weight may not connect their symptoms to a sleep issue. They can go for years without a proper diagnosis. Research also makes it clear that OSA can show up in people who are not obese. Risk may be more than weight-dependent and include factors such as upper airway anatomy, age, sex, family history, and others.
Weight is only part of the story. The jaw, the palate, the tongue, and the passages in the upper throat can affect what happens during sleep. The airway can narrow or collapse more easily for some people. A person may not be big in body size but can have a tight or smaller upper airway. They might have a jaw that drops back. Other facial and skull features can also increase the likelihood of OSA. Your nose problems, smoking, drinking and other unwholesome activities on Sunday could also be factors.
Age matters too. With time, muscle tone can change. The way the airway works can also shift. As a result, the upper airway may be more likely to collapse during sleep. For women, the risk may also shift around menopause and after it. This is why OSA should not be treated as a problem that only affects overweight men.
The symptoms should be taken seriously, not the scale. Signs such as loud snoring or snoring often, pauses seen in breathing, waking up suddenly and feeling short of breath, or choking during sleep can all call for assessment. Morning headaches can occur as well. Day-to-day problems like poor focus, irritability, and being very sleepy in the daytime are common clues. Some people do not report classic sleepiness. They may mainly notice restless sleep or ongoing tiredness during the day without a clear reason
A clinician should look at more than BMI. They can start with symptoms, a sleep history, neck size, what the upper airways look like, and any related health issues.
If obstructive sleep apnoea is a real concern, a sleep test can show whether breathing problems happen during sleep.
The main point is this: a person can be slim and still have sleep apnoea. Deciding on testing should follow the full clinical picture, not body weight by itself. When this is remembered, some people may get help sooner, instead of having their tiredness written off as stress, bad sleep, or just normal fatigue.
Dr. Arup Haldar is a consultant Pulmonologist in the Department of Pulmonary Medicine at CMRI Hospital. He has more than 15 years’ experience in Pulmonary Medicine. He began his career at Columbia Asia Hospital, where he remained for 12 years. He was also attached to Woodlands Hospital for 10 years as a consultant. Apart from general Pulmonology, his core area of interest is Sleep Medicine, especially Sleep-Disordered Breathing. He has been engaged in Polysomnography for the last 13 years and has published several research papers in this area.
He is also an academician and is engaged in teaching and training people interested in sleep medicine. He has presented his work at various national and international conferences. He has published numerous scientific papers in national and international journals.
He is also keenly involved in air pollution-related diseases and in activities to raise awareness against air pollution. He is a Mentor in the ‘Medical Student Clean Air Ambassador Program’ by SwitchON Foundation.
He is a faculty member of the World Sleep Academy, an academic wing of the World Sleep Society. He is a content writer there. He is also a member of the Indian Chest Society and the European Respiratory Society.