News
Obstructive sleep apnoea kills while you sleep …
World Sleep Day tomorrow
The Sleep Assembly of the Sri Lanka College of Pulmonologists will launch sleepbetter.lk web page tomorrow (18) to coincide with the World Sleep Day.
Dr. Chandimani Undugodage, Consultant Respiratory Physician and Senior Lecturer Faculty of Medical Sciences, University of Sri Jayawardenepura says Obstructive Sleep Apnoea (OSA) makes people vulnerable to diabetes, high blood pressure, heart attacks or strokes.
Addressing the media at Ramada on Tuesday (15), Dr. Undugodage said that snoring at night, sleeping during daytime and being overweight could be symptoms of one having OSA.
What is OSA?
Obstructive sleep Apnoea is a condition where you stop breathing during sleep. This occurs as a result of temporary closure of the upper airway that carry air to the lungs. Obesity is commonest risk factor for development of OSA.
What happens in OSA?
The airway that carries air to the lungs passes through the throat or the upper airway. When a person gains weight there is a lot of fat deposited in the neck, which makes the upper airway narrow.
When a person is awake, the airway is kept open by the muscles of the throat. But when he goes to sleep all the muscles relax and the already narrow airway becomes even narrower. When air passes in and out through this narrow airway it makes a noise, which is what snoring is. As the person goes into deep sleep, the muscles of the throat relax further and the airway becomes narrower; at one point the airway completely closes; then there is no movement of air in to the lungs and the person completely stops breathing. This is known as an “apnoea”
When this happens there is no air/oxygen going in to the lungs; which results in low levels of oxygen in the blood, brain and other organs. When the brain senses that the person is not breathing, it immediately brings the person from deep sleep to light sleep, or completely wakes that person up. Then the airway opens out and the person starts to breathe again. In those with OSA this happens over and over again in the night. Which leads many awakenings, with very little uninterrupted deep sleep. In the morning the person wakes up feeling unrefreshed and is sleepy during the day. This can result in loss of productivity during the day. Especially by falling asleep during work, at meetings and even while driving leading to road traffic accidents.
An episode of obstructive apnoea where the throat closes during sleep is comparable to strangulation. Imagine if someone strangles you, what will happen? You will panic, your heart rate will go up, blood pressure will go up and you would be under a lot of stress. A similar situation occurs during an apnoea in OSA. It produces a stressful situation in the body. There is release of stress hormones in to the blood. This leads to elevated blood pressure and blood sugar. With time this leads is development of diabetes and high blood pressure (hypertension). There is also a higher risk of getting a heart attack, stroke, abnormal heart rhythms (arrhythmias) and dying suddenly while asleep (sudden cardiac death). OSA patients can also suffer from impotence. With time they become forgetful and there can be changes in their personality
When should you suspect OSA?
How is OSA diagnosed?
If you think you have OSA, you have to talk to your doctor. He or she will refer you to a specialist. A comprehensive sleep assessment will be done to look for other sleep related disorders. An overnight sleep study will be done to look for OSA. This is a simple test where your breathing, air flow, oxygen levels and heart rate are monitored and recorded. Once the data is looked at whether you have OSA or not can be determined.
How is OSA treated?
As OSA is about the closure of the throat during sleep, the treatment is aimed at keeping the throat open. The two main ways of treatment that is available in Sri Lanka are treatment with Continuous Positive Airway Pressure ventilation (CPAP) and surgery. CPAP – this is a small machine with a mask. The person wears the mask when going to sleep. The machine produces a jet of air which splints the airway open, without letting it close. Snoring stops immediately and the person wakes up refreshed in the morning
Surgery – surgical therapy is aimed at making the airway larger and thereby stopping the airway from closing. There are many types of surgeries available.
In addition weight reduction by diet and exercise is advised.
News
Judicial vacancies: President keeps country guessing
The NPP government has not taken a final decision regarding filling of the vacancies in the judiciary.
A group of Opposition MPs, led by SJB leader Sajith Premadasa, on 12 June, requested Speaker Dr. Jagath Wickremeratne to take up the issue of judicial vacancies with President Dissanayake. Opposition sources said that there were four vacancies, each in the Court of Appeal and the Supreme Court, and the inordinate delay had adversely affected the judiciary.
Government sources indicated that there was no change in the status quo as regards filling of vacancies. Referring to the government proposal to extend the retirement age of judges, authoritative sources said that no final decision had been taken yet.
SJB lawmaker Dayasiri Jayasekera told The Island that they would raise the issue in Parliament this week.
He said that the deliberate delay in making appointments to superior courts and the move to extend the retirement age couldn’t be taken separately.
The MP noted that the Bar Association of Sri Lanka, the Lawyers’ Collective, the Colombo High Court Lawyers’ Association, Colombo Magistrate’s Court Lawyers’ Association and the Bar Association of Badulla had opposed the government move.
There hadn’t been any public statements in support of the government move, MP Jayasekera said, urging the government to end uncertainty in the judiciary.
by Shamindra Ferdinando
News
Sajith calls on Opposition parties to rally around SJB
SJB leader Sajith Premadasa has invited the UNP and other political parties to join his party. Premadasa, who is also the leader of the Opposition, has emphasised that the UNP and the SJB could reach a consensus on policies but his party wouldn’t, under any circumstances, accept whatever formula to share positions. Premadasa said so, speaking to the media over the weekend, after meeting the Mahanayaka Thera of the Malwatta Chapter of the Siyam Nikaya Most Venerable Thibbatuwawe Sri Siddhartha Sumangala Thera.
A statement issued by the Opposition Leader’s Office quoted MP Premadasa as having extended an invitation to all political parties to give up extremist policies and join the SJB.
The SJB leader alleged that the NPP government feared facing elections and that was the reason for the inordinate delay in holding Provincial Council polls. PC polls were last held in 2012, 2013 and 2014, on a staggered basis. Premadasa said that if PC polls were held his party would definitely win the majority of PCs.Premadasa also urged the government to reduce electricity tariffs and fuel prices.
News
Ex-EC Chief slams govt. over PC polls delay
Former Chairman of the Election Commission, Mahinda Deshapriya, on Saturday, strongly criticised the continued postponement of local government elections, declaring that every day without elections constitutes a violation of both the Constitution and democratic principles.
Speaking during an interview with journalist Bhanuka Rajapaksa, on Hiru TV, on Saturday, Deshapriya described the current administration of local government institutions by unelected officials as fundamentally undemocratic and contrary to the spirit of representative governance.
Deshapriya said local authorities, across the country, are presently being managed by secretaries and bureaucrats rather than elected representatives, depriving citizens of their democratic right to be governed by individuals, chosen through the electoral process.
“If the Constitution recognises and provides for local government institutions, then it is the responsibility of the State to ensure that elections are held and that these bodies are administered by representatives, elected by the people,” he said.
Deshapriya rejected attempts to justify the prolonged delay, arguing that responsibility for the situation rests with the government.
He noted that while various political parties have publicly stated their readiness to face elections, the ruling administration possesses the authority to resolve any issues relating to the electoral system.
The former Election Commission chief pointed out that the government enjoyed a two-thirds majority in Parliament, enabling it to enact any legislative amendments required to facilitate the conduct of elections. Instead, he said, successive committees and review processes had been used to postpone a final decision.
He also referred to efforts by opposition legislators who have moved motions seeking to address concerns relating to the electoral framework and expedite the holding of local government polls.
Deshapriya warned that any attempt to appoint a fresh delimitation committee could further delay the electoral process, making it unlikely that local government elections would be held within the current year.
He also dismissed claims that financial constraints have prevented the conduct of elections. Expressing surprise at such assertions, he questioned how funding shortages could be cited as a reason for postponement while expenditure continues in other sectors.
According to Deshapriya, the existence of laws establishing local government institutions imposes an obligation on the State to ensure that those institutions are populated through democratic means.
“The legal framework exists. If elected representatives are not appointed through elections and institutions continue to function under unelected administrators, that is a failure of the State,” he said.
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