Multimodal Ayurvedic Management of Obstructive sleep apnea (OSA) linked Pickwickian Syndrome (Obesity Hypoventilation Syndrome) (Sthaulya with Shwaskruchrata): A Case Report
DOI:
https://doi.org/10.70066/jahm.v14i5.2848Keywords:
Ayurveda, Case Report, Nasya, Obesity Hypoventilation Syndrome, Obstructive Sleep Apnea, Pickwickian Syndrome, Sleep Disorder, Virechana, Yoga.Abstract
Background: Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder comes under purview of Obesity hypoventilation Syndrome (OHS) categorized by recurrent upper airway obstruction during sleep, resulting in snoring, excessive daytime sleepiness, fatigue, and impaired quality of life. Obesity is a major risk factor for OSA and contributes significantly to disease progression. Clinical Findings: A 38-year-old obese male (Body Mass Index (BMI) 32.5 kg/m²) presented with loud snoring, excessive daytime sleepiness, fatigue, drowsiness, disturbed sleep, recurrent upper respiratory symptoms, and progressive weight gain over six years. The patient had experienced two road traffic accidents secondary to excessive sleepiness while driving. STOP-BANG and Berlin questionnaires indicated a high risk of OSA, while the Epworth Sleepiness Scale (ESS) score was 16, suggesting excessive daytime sleepiness. Interventions: The patient underwent a multimodal Ayurvedic treatment protocol comprising Udwartana (powder scrubbing) Utsadana (oil mixed powder scrubbing) Parisheka (Pouring of Medicated decoction externally) Pradhamana Nasya with Vacha Churna (Nasal Instillation of Powder Drugs) and Lashuna Swarasa, Shadbindu Taila Nasya, Snehapana (Internal Oleation) with Panchatikta Guggulu Ghrita, Virechana (Therapeutic Purgation) internal medications (Vyoshadi Vati, Triphala Guggulu), and yoga practices including selected asanas and pranayama. Post-discharge medications and lifestyle modifications were advised. Outcome Marked improvement was observed in snoring, daytime sleepiness, fatigue and sleep quality. ESS score reduced from 16 to 0, Berlin Questionnaire categories changed from positive to negative, and STOP-BANG responses showed good clinical improvement. BMI decreased from 32.5 to 28.35 kg/m². No adverse events were reported. Conclusion This case demonstrates the potential role of a comprehensive Ayurvedic approach incorporating Panchakarma, internal medications and yoga in the management of obesity-induced OSA. Significant improvements were observed in clinical symptoms, sleep-related outcomes- Epworth Sleepiness Scale, Berlin Questionnaire Categories and body weight without any adverse effects, further large studies are warranted in order to validate this finding.
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