Sleep Disorders We Evaluate & Manage
Persistent sleep problems should not simply be accepted as a normal part of life. We provide comprehensive clinical evaluation for a wide spectrum of sleep conditions.
Obstructive Sleep Apnea (OSA)
Repeated narrowing or blockage of the upper airway during sleep can interrupt normal breathing, leading to sudden oxygen drops, cardiac strain, and repeated subconscious awakenings throughout the night.
Common Symptoms
- • Loud, habitual snoring with choking/gasping
- • Observed pauses in nighttime breathing
- • Excessive daytime fatigue & morning headaches
Diagnostic Pathway
Level-1 Overnight Polysomnography (PSG) to determine Apnea-Hypopnea Index (AHI) or Home Sleep Apnea Testing (HSAT).
Evidence-Based Care
CPAP/APAP therapy, positional guidance, weight management support, or targeted airway evaluation.
Habitual & Disruptive Snoring
Persistent or loud snoring occurs when air forces its way through a narrowed airway, vibrating tissues. While sometimes benign, it is frequently associated with an underlying sleep-related breathing disorder or Upper Airway Resistance Syndrome (UARS).
Key Warning Signs
- • Snoring heard through closed doors
- • Restless tossing and dry mouth on waking
- • Partner disturbed by erratic breathing volume
Clinical Assessment
Detailed nasal and pharyngeal examination to evaluate tonsillar hypertrophy, soft palate laxity, or nasal septum deviation.
Management
Differentiating simple primary snoring from OSA, followed by custom oral appliances, sleep-position therapy, or CPAP.
Chronic Insomnia
Difficulty falling asleep, staying asleep through the night, or waking up too early in the morning can severely degrade daytime concentration, emotional stability, and overall immune health.
Characteristics
- • Lying awake for more than 30–45 minutes
- • Conditioned hyperarousal when approaching bed
- • Daytime anxiety and irritability regarding sleep
First-Line Treatment
Cognitive Behavioural Therapy for Insomnia (CBT-I) to systematically dismantle sleep anxiety without drug dependency.
Safe Medication Advice
Strict medical oversight. We caution patients against self-medicating with over-the-counter sleeping pills or sedatives.
Excessive Daytime Sleepiness (EDS)
Unusual or persistent sleepiness during daytime waking hours—such as nodding off during conversations, meetings, or driving—is an indicator of inadequate or fragmented nocturnal sleep, or specific central hypersomnia disorders.
Causes Evaluated
Sleep apnea, chronic sleep deprivation, narcolepsy, or upper airway resistance.
Investigations
Overnight PSG followed by daytime Multiple Sleep Latency Test (MSLT).
Management
Resolving primary sleep fragmentation, sleep schedule optimization, and clinical wakefulness support.
Restless Legs Syndrome (RLS)
An uncomfortable urge to move the legs, particularly during periods of rest, reclining, or at night. The sensations are typically accompanied by crawling, tingling, or pulling sensations temporarily relieved by movement.
Clinical Diagnostic Criteria
Urge to move legs beginning or worsening during inactivity, partially relieved by walking or stretching.
Underlying Factors
Iron store evaluation (serum ferritin), renal function check, and peripheral neurological screening.
Treatment Strategy
Correction of iron levels, lifestyle adjustments, and targeted non-dopaminergic or dopaminergic medications when indicated.
Circadian Rhythm Sleep Disorders
Problems with the body's sleep-wake timing can make it difficult to fall asleep and wake at socially or professionally desired times. Common presentations include Delayed Sleep Phase Syndrome (night owls unable to sleep before 3:00 AM) and shift work disorder.
Parasomnias & Unusual Sleep Behaviours
Unusual behaviours, movements, or experiences occurring while falling asleep, during sleep, or during arousal—such as sleepwalking (somnambulism), sleep terrors, sleep talking, or REM Sleep Behaviour Disorder (acting out vivid dreams).
Narcolepsy
A chronic neurological sleep disorder characterized by excessive daytime sleepiness, irresistible sleep attacks, and in some cases sudden muscle weakness triggered by strong emotions (cataplexy), sleep paralysis, or hypnagogic hallucinations.