Sleep Medicine at KIMS Electronic City, Bengaluru

Sleep-disordered breathing is a pulmonology problem

Sleep apnea is a breathing problem that happens when you are asleep. It belongs to pulmonology - not ENT, not neurology - because it is fundamentally about how the airway behaves during sleep and how gas exchange fails when it collapses. Yet most patients in India only discover they have obstructive sleep apnea after years of unexplained fatigue, worsening blood pressure, morning headaches, or a bed partner who moved to a separate room because of snoring.

Dr. Manjunath M Negigoudara runs a structured sleep medicine clinic at KIMS Hospital, Electronic City covering the full pathway: evaluation, sleep study, treatment, and long-term adherence review.

Conditions we evaluate and treat

Obstructive sleep apnea (OSA) - the most common. Upper airway collapses repeatedly during sleep. Snoring, gasping awakenings, daytime sleepiness.
Central sleep apnea - brain doesn’t send the signal to breathe. Often related to heart failure, stroke, or opioid use.
Sleep-related hypoventilation - insufficient breathing during sleep, causing CO₂ retention. Common in obese patients or those with neuromuscular disease.
Overlap syndrome - OSA + COPD together. Higher mortality than either alone. Usually needs BiPAP rather than CPAP.
Obesity hypoventilation syndrome - BMI > 30 + daytime CO₂ retention. Volume-targeted BiPAP + weight management.
Pre-surgery OSA screening - STOP-BANG assessment before major surgery reduces peri-operative complications.
CPAP intolerance / non-adherence - structured review programme for previously-diagnosed OSA patients not using their device.

Signs you should get a sleep study

Common patterns that should prompt evaluation:

Loud, disruptive snoring with witnessed gasping or breathing pauses
Unrefreshing sleep despite adequate hours
Daytime sleepiness - falling asleep in meetings, at traffic lights, while reading
Morning headaches
Memory or concentration problems
Treatment-resistant high blood pressure (needing 3+ medications)
Atrial fibrillation, especially recurrent after cardioversion
Type 2 diabetes not responding well to standard therapy
Bed partner refusing to share the bedroom because of snoring

If your partner has stopped sleeping in the same room because of your snoring, that is a clinical sign - not a relationship problem. Get evaluated.

Why treating sleep apnea matters

Untreated OSA carries roughly 2-3× higher all-cause mortality vs age-matched controls, and is a proven driver of resistant hypertension, atrial fibrillation, stroke, type 2 diabetes, fatty liver disease, and higher road accident risk. Treating OSA properly is disease-modifying, not cosmetic.

The sleep study - what to expect

Level-1 in-lab polysomnography

The gold-standard test. You spend a night at the KIMS sleep lab wearing sensors that continuously record: brain waves (EEG), eye movements (EOG), muscle activity (EMG), heart rhythm (ECG), airflow, chest and abdominal breathing effort, oxygen saturation, and body position. A sleep technologist monitors throughout the night. Results are typically available within 3-5 days.

Diagnoses possible: OSA (obstructive events), central apnea (no effort), hypoventilation (rising CO₂), periodic limb movements, REM behaviour disorder, narcolepsy features.

Home sleep test

A portable device you wear at home for one night. Measures airflow, chest/abdominal effort, oxygen saturation, and heart rate. Useful for high-probability OSA cases without significant comorbidity. Cheaper and more convenient than an in-lab study - Dr. Manjunath M Negigoudara recommends the right test at your first visit based on your clinical picture (comorbidities, suspicion of central events, etc).

CPAP and BiPAP therapy

How CPAP works

Titration - setting the right pressure

The correct pressure depends on your specific pattern of events, body position, and REM/non-REM sleep stages. Options:

In-lab manual titration - a second night in the sleep lab with progressive pressure adjustments until events resolve. Gold standard for complex cases.
Auto-titrating device (APAP) - the device adjusts pressure night-to-night based on airflow signals. Suitable for straightforward OSA.
BiPAP - separate inspiratory and expiratory pressures. Needed for hypoventilation, overlap syndrome, and high-pressure requirements uncomfortable on CPAP.

Long-term adherence review

Modern CPAP machines record every night’s usage - hours worn, residual apnea events, mask leak, pressure delivered - and upload to a cloud portal. At quarterly reviews we look at the data and troubleshoot problems (mask leak, dry mouth, claustrophobia, ramp settings, mode changes). Very few patients truly cannot be helped by structured adherence support.

When CPAP is not enough - alternatives

For patients with genuine CPAP intolerance despite mask changes + humidification + pressure adjustments:

Mandibular advancement devices - custom dental appliances for mild-moderate OSA
Positional therapy - if events only occur supine
Weight loss - directly reduces upper-airway crowding
Upper-airway surgery - referred to ENT (UPPP, maxillomandibular advancement, tongue base reduction) for select anatomical patterns
Hypoglossal nerve stimulation - implant option for CPAP-intolerant moderate-severe OSA (not yet widely available in India)

Book a sleep consultation

Bring your bed partner if possible - their witness of snoring pattern and breathing pauses is clinically useful. Also bring: prior sleep study reports (if any), current BP and HbA1c readings, list of medications (especially sedatives, antihistamines, opioids), and any fitness-tracker sleep data or home oximetry recordings.

Call +91 79937 41199 · WhatsApp · Book online. Also see: sleep apnea specialist in Bangalore, best pulmonologist Electronic City.

Frequently asked questions

What sleep conditions does Dr. Manjunath M Negigoudara treat?

Obstructive sleep apnea (OSA - the most common), central sleep apnea, sleep-related hypoventilation, overlap syndrome (OSA + COPD), obesity hypoventilation syndrome, complex sleep-disordered breathing, and CPAP intolerance / non-adherence in previously-diagnosed OSA. Also pre-surgery sleep apnea screening.

Do I need a sleep study before CPAP?

Yes. Starting CPAP without a formal sleep study is not clinically appropriate - the correct pressure setting and mask type depend on the specific pattern of apneas, oxygen desaturation, and body position seen during monitored sleep. A level-1 in-lab polysomnography is the gold standard; a home sleep test is acceptable for high-probability OSA cases without significant comorbidity.

What is the difference between an in-lab sleep study and a home sleep test?

In-lab level-1 polysomnography monitors EEG, EOG, EMG, ECG, airflow, chest + abdominal effort, oxygen saturation, and body position through the night at a dedicated sleep lab. It diagnoses OSA, central apnea, hypoventilation, periodic limb movements and more. Home sleep tests are portable devices measuring fewer channels (typically airflow, effort, oximetry, heart rate) - useful for high-probability OSA without significant comorbidity. Dr. Manjunath M Negigoudara recommends the right test at your first visit based on your clinical picture.

How does CPAP therapy work?

Continuous Positive Airway Pressure delivers a steady stream of air through a mask worn during sleep, splinting the upper airway open and preventing the collapses that cause apnea. It is worn nightly, indefinitely - like glasses for your airway. Most patients feel dramatically better within 1-2 weeks of consistent use: refreshing sleep, daytime alertness returns, blood pressure often improves, long-term cardiovascular risk drops.

What if I cannot tolerate CPAP?

CPAP intolerance is common initially - claustrophobia, dry mouth, air swallowing, pressure discomfort. Most is solved with mask changes, humidification, ramp-mode settings, or switching from CPAP to BiPAP (separate inspiratory + expiratory pressures, more comfortable at high pressures). For genuine non-users, alternatives include mandibular advancement devices, positional therapy, weight loss, and select upper-airway surgery referred to ENT. Structured adherence review is part of standard care.

How is sleep apnea linked to blood pressure, diabetes and heart disease?

Untreated OSA is a proven independent risk factor for hypertension (especially treatment-resistant), atrial fibrillation, heart failure, stroke, type 2 diabetes, non-alcoholic fatty liver disease, and higher all-cause mortality. Every apnea causes a surge in blood pressure and sympathetic tone. Treating OSA properly is disease-modifying, not cosmetic.