Sleep disorders are often overlooked by doctors, leading to significant problems. While COVID highlighted the importance of oxygen levels, sleep disorder patients experience chronically low oxygen levels during sleep, which is even more concerning.
In an exclusive interview with The Gray Matter, we had the privilege to sit down with Dr Shivani Swami, a distinguished expert in the field of sleep medicine. Dr Swami's journey began with a background in Pulmonology, but it was a chance encounter with a passionate mentor that sparked her interest in sleep disorders. Over a decade ago, she became one of the first few in the country to undergo specialized training in sleep medicine, making her a true pioneer in the field. Today, armed with extensive knowledge and expertise, she continues to make a profound impact on the lives of her patients, improving their quality of sleep and overall well-being. In this captivating interview, we take a closer look at Dr Shivani Swami's illustrious sleep medicine career and her remarkable contributions to the field in India.
1. What inspired you to pursue sleep medicine?
After completing my MD in Pulmonology, sleep medicine wasn't my primary focus until I met Dr. Himanshu Garg during a fellowship interview at Medanta. His contagious passion for sleep medicine ignited my interest, leading me to pursue a one-year sleep fellowship program in 2010. I was fortunate to be among the five students selected across India for this specialized training, making me one of the pioneers in the country. After more than 13 years in the field, I am proud of the knowledge and expertise I gained, enabling me to provide comprehensive care to patients with sleep disorders and contribute to the advancement of sleep medicine.
2. What are the most common sleep disorders patients come to you with?
The most common sleep disorder is insomnia, characterized by the inability to get sufficient sleep. However, I find this term misleading because as we age, our sleep needs decrease. The society promotes the notion of 6 to 8 hours of sleep as essential, causing the elderly to complain about insufficient sleep. Another prevalent sleep disorder I feel strongly about as a pulmonologist is obstructive sleep apnea, where breathing stops during sleep. Additionally, there are rare sleep-related movement and behavioral disorders, like sleep talking, sleepwalking, sleep eating, and abnormal limb movements during sleep.
3. How can a person know that they might have a sleep disorder and need to get checked?
Sleep disorders are often overlooked by doctors, leading to significant problems. While COVID highlighted the importance of oxygen levels, sleep disorder patients experience chronically low oxygen levels during sleep, which is even more concerning. Common symptoms include snoring, disturbed sleep, frequent awakenings, choking sensations, morning headaches, and excessive daytime sleepiness due to compromised sleep quality. Recognizing and addressing these issues is important for their overall health.
4. How can other specialties help sleep medicine by helping their patients point out their sleep disorders?
In India, adopting a multidisciplinary approach to patient care is crucial. Many individuals with specific health conditions seek treatment from specialists, but it's essential to recognize that underlying sleep problems may contribute to their health issues. Involving various specialists, such as neurologists, and proactively addressing sleep-related problems can lead to better outcomes. Patients tend to be more accepting of their condition and diagnosis when they receive referrals from other specialties, making the multidisciplinary approach even more effective. Collaboration and proactive recognition of sleep problems are vital for comprehensive patient care.
5. What are the different treatment options for people with sleep disorders?
Based on the disease severity, which we categorize as mild, moderate, or severe, we have various treatment options available. For mild cases, lifestyle changes and positional therapy may suffice, and in some instances, an oral device could be used. In children, addressing issues like adenoid or tonsil problems and sinus issues may prove beneficial. However, for patients with moderate to severe problems, the gold standard treatment is positive airway pressure therapy. This therapy is tailored to the individual's needs, ensuring the most effective and appropriate approach for each patient.
6. Can you just describe the process of a sleep test?
We assess patients' sleep issues like sleep deprivation, snoring, and choking sensations, and how they impact daily life and sleepiness levels. If sleep apnea is suspected and other causes are ruled out, we proceed with a sleep study. This involves monitoring brain activity, oxygen levels, heart, body movements, and respiratory movements in a home-like environment overnight. After analyzing the data, we provide counseling tailored to address their specific sleep problems.
7. Could you kindly share a success story of one of your patients who underwent sleep therapy and experienced a significant improvement in their quality of life? It would be inspiring for our readers.
A 102 kg lady admitted to the ICU with low oxygen levels showed remarkable improvement after sleep therapy. She received a sleep machine and, within weeks, started losing weight, becoming more active and engaged in exercise. Now, 37 kg lighter, she inspires her relatives to address their own health issues, proving that positive changes are possible with the right support.