Sleep Apnea Treatment in Hyderabad: Diagnosis, CPAP & Beyond
Diagnosis, CPAP, Surgery & Integrated Care at Respire
Sleep apnea is a breathing disorder where the airway repeatedly collapses during sleep, cutting off oxygen and breaking sleep continuity throughout the night. Most patients are unaware it is happening. The consequences accumulate silently: uncontrolled blood pressure, cardiovascular risk, cognitive decline, and exhaustion that no amount of sleep seems to fix.
Medical disclaimer: This content is reviewed by Dr. Pradyut Waghray, MBBS MD FRCP (London) FCCP FAMS. It is for informational purposes only and does not replace a medical consultation.
Last reviewed: 2026-05-10 by Dr. Pradyut Waghray
Written and reviewed by Dr. Pradyut Waghray, MBBS MD FRCP (London) FCCP FAMS, Founder, Respire Airway Clinics, Hyderabad.
At Respire in Hyderabad, sleep apnea is diagnosed and treated by Dr. Pradyut Waghray (FRCP London, 37+ years in pulmonary and sleep medicine) and Dr. Kunal Waghray (DM Pulmonology). Diagnosis starts with a home sleep study in your own bed. Treatment is matched to your AHI, anatomy, and tolerance, not a standard protocol.
Dr. Pradyut Waghray, Pulmonology Respiratory Medicine Specialist, 37+ Years of Experience
Partners are often the first to notice
Most people with sleep apnea have no memory of their episodes. The pauses, the gasps, the restless rolling: a bed partner observes all of it. That observation is clinically significant. A witnessed apnea is one of the strongest predictors of moderate-to-severe OSA.
If a partner has mentioned any of these, that observation is worth acting on. A home sleep study takes one night and gives a definitive AHI.
What Is Obstructive Sleep Apnea?
The tissues at the back of your throat relax during sleep. In most people they go loose but the airway stays open. In obstructive sleep apnea (OSA), they collapse: the airway closes, oxygen drops, the brain fires an alarm, and you wake just enough to reopen it. You do not remember any of this. In moderate-to-severe OSA it happens dozens of times an hour, all night. For a fuller primer, see what is sleep apnea.
Severity is measured by the AHI (Apnea-Hypopnea Index, the number of breathing interruptions per hour of sleep). The American Academy of Sleep Medicine defines the bands as follows:
In our clinic, we routinely see patients walk in with an AHI above 40 who have never had a sleep study. They came in for snoring, or because a family member pushed them.
Not All Sleep Apnea Is Obstructive
OSA accounts for the majority of cases, but not all of them.
Central sleep apnea (CSA) is a different mechanism. The airway stays open, but the brain intermittently stops sending the signal to breathe. It is more common in patients with heart failure, stroke, or those on long-term opioid medication. The treatment is different too: standard CPAP pressure can actually worsen CSA by suppressing the respiratory drive further. If we suspect central events on the home study, we order full in-lab polysomnography before starting any therapy.
Complex sleep apnea starts as OSA but develops central apnea events once CPAP is established. It is one reason we review every CPAP starter at four weeks. Dr. Kunal Waghray checks for treatment-emergent central events in the titration data and adjusts the device mode if needed.
Overlap syndrome is OSA coexisting with COPD or asthma. The oxygen drops during apnea are steeper than in OSA alone, and the cardiovascular risk is compounded. We see this combination regularly. Urban air quality and a high background rate of asthma in Hyderabad make overlap more common here than the published figures suggest.
Who Is at Risk?
Risk goes up with age over 40, neck circumference above 16 inches in women and 17 inches in men, a BMI above 27, retrognathia (a recessed jaw), large tonsils, and a family history of OSA. Hypertension that does not respond well to medication is another quiet flag.
Pregnancy raises risk substantially in the third trimester: weight gain, fluid retention, and upper airway oedema narrow the passage. Untreated OSA in pregnancy is linked to gestational hypertension and pre-eclampsia; it is one of the most under-screened high-risk groups we see. Older adults over 65 have OSA rates two to three times the general adult average, but the daytime sleepiness is routinely attributed to age and never investigated.
India carries a higher OSA burden than most clinicians assume. A community-based study of 2,505 urban Indians in Delhi found OSA (AHI ≥5) in 9.3% of adults aged 30 to 65, roughly 1 in 11, with most undiagnosed (Sharma et al., Sleep Medicine 2009). The Hyderabad profile concentrates the risk further: long desk hours, late evening meals, a high prevalence of metabolic syndrome, and low baseline awareness that sleep disorders are treatable medical conditions rather than personal habits.
Sleep Apnea Symptoms to Watch For
The classic signs:
Women often present differently. Instead of obvious snoring, the leading complaint is fatigue, insomnia, or low mood. Several women we see were treated for depression for years before anyone ordered a sleep study.
We screen most adults with the Epworth Sleepiness Scale at the first visit. It takes two minutes and gives us a baseline number to track against treatment.
How We Diagnose Sleep Apnea at Respire
Diagnosis starts with the airway, not the machine.
Dr. Jyotika Waghray examines the nose, palate, tongue base, and tonsils before anything else. It takes about 20 minutes, and it catches contributors (a deviated septum, enlarged tonsils, a narrow soft palate) that a questionnaire never would.
From there, most patients go home the same day with a home sleep study in Hyderabad kit. The setup is unglamorous: a small clip on your finger, an elastic band around your chest, a soft tube under your nose, a pulse sensor on your wrist. You sleep in your own bed. Drop the device back the next morning. Results are usually with us within 48 hours.
Some cases need more. If the home study is inconclusive, or if we suspect central apnea or a complex overlap with lung disease, we order in-lab polysomnography: a full overnight study with EEG, ECG, leg leads, and video. It is not the standard starting point. But it is the right one when the picture is incomplete.
DISE only enters when surgery is being considered. Drug-Induced Sleep Endoscopy (a 15-minute camera examination of the airway during medically-induced sleep) shows us exactly where the airway collapses: the soft palate, the tongue base, the lateral walls, or all three at once. Without it, surgery is a guess. With it, we operate on the right structure.
The Health Risks of Untreated Sleep Apnea
The damage is not confined to your sleep quality.
Hypertension
Each apnea event triggers a cortisol and adrenaline spike. Repeat this dozens of times a night for years, and the result is sustained blood pressure elevation that does not respond normally to antihypertensive medication. Patients presenting with resistant hypertension (blood pressure that stays high despite two or three medications) are now routinely screened for OSA in our clinic. A significant proportion have it.
Type 2 Diabetes
Intermittent hypoxia and fragmented sleep both impair insulin sensitivity independently. The relationship runs both ways: metabolic syndrome increases OSA risk, and untreated OSA worsens glycaemic control. Patients managing diabetes who cannot stabilise their HbA1c are worth investigating for sleep apnea.
Cardiac Arrhythmias
Atrial fibrillation is substantially more common in untreated OSA than in the general population. In one case-control study, OSA patients were 2.19 times more likely to have AF even after adjusting for age and weight (Gami et al., Circulation 2004). The mechanism is nocturnal oxygen desaturation driving electrical remodelling of the atria. Several of our patients were referred from cardiologists specifically for this reason.
Depression and Cognitive Decline
The overlap between OSA and depression is high enough that sleep medicine now treats it as a routine differential. Memory problems, low motivation, and poor concentration that have not responded to psychiatric treatment are worth re-evaluating with a sleep study. We have seen patients who spent years on antidepressants before the OSA diagnosis.
GERD
The negative intrathoracic pressure generated during obstructed breathing events pulls gastric acid upward. CPAP, once established, frequently reduces reflux as a secondary effect; patients often notice this before they notice the sleep improvement.
Sleep Apnea Treatment Options at Respire
Treatment depends on AHI, anatomy, lifestyle, and what the patient will actually use at 3 a.m.
CPAP and BiPAP Therapy
CPAP (Continuous Positive Airway Pressure, a machine that keeps the airway open during sleep) remains the first-line treatment for moderate and severe OSA. We titrate pressure during a sleep study or use an auto-CPAP for the first month, then refine.
If you are pressure-intolerant on CPAP, we move to BiPAP, which uses a lower pressure on exhalation. If you are mask-intolerant, we work through three to four mask styles before calling it a fail. Most patients who say “I've been told I need CPAP but I'm not sure it's right for me” turn out to have been fitted poorly the first time.
Read more about CPAP therapy at Respire.
Surgical Treatment
Surgery is not a first option, but it is the right option for a specific group: patients with clear anatomical obstruction on DISE, patients who have genuinely failed CPAP, and patients with very large tonsils or a deviated septum driving the obstruction.
Procedures we perform or coordinate:
Septoplasty
For a deviated nasal septum that blocks CPAP tolerance or contributes to obstruction
Tonsillectomy and adenoidectomy
In patients with grade 3 or 4 tonsils
UPPP (uvulopalatopharyngoplasty)
In selected palate-level collapse
Tongue-base reduction or hypoglossal nerve stimulation
In tongue-base collapse on DISE
Details and recovery timelines are on the sleep apnea surgery in Hyderabad page.
Non-CPAP Alternatives
For mild to moderate OSA, or for patients who refuse CPAP:
Mandibular advancement devices (MAD)
A custom dental appliance that holds the lower jaw forward
Positional therapy
For patients whose AHI is high only when supine
Weight reduction
Even a 10% drop in body weight typically lowers AHI by around 20 to 30%
Myofunctional therapy
Tongue and oropharyngeal exercises with measurable AHI reduction in mild cases
A full breakdown lives on the CPAP alternatives page.
Why Integrated Care Changes the Outcome
Most sleep apnea is not purely a lung problem or purely an ENT problem. It is an airway problem, and the airway crosses both specialties.
In a single visit, Dr. Jyotika Waghray examines the upper airway (the nasal passages, palate, tongue base, and tonsils) while Dr. Kunal Waghray (DM Pulmonary Medicine, 1,000+ bronchoscopies) assesses the lower airway, oxygenation patterns, and any overlap with asthma or COPD.
Dr. Pradyut Waghray holds the two threads together. As the sleep physician, he reads both assessments alongside the sleep study data and writes a single treatment plan. Not two separate opinions. One plan.
The DISE advantage is real. When surgical patients are evaluated under DISE before any procedure, the target is precise: we operate on the structure that is actually collapsing, not the one we assumed. We follow up at 3 months and 6 months, with a repeat sleep study at 6 months if you are on therapy.
Your First Appointment: What to Expect
No referral is needed. You can call Basheer Bagh or Jubilee Hills directly and book.
We set aside 30 to 45 minutes for the first visit. You will sit with Dr. Pradyut Waghray and walk through your history, your Epworth Sleepiness Scale score, and any recordings or reports you have brought. Dr. Jyotika Waghray's ENT examination and Dr. Kunal Waghray's pulmonary review happen in the same building, same day.
Before you leave, you will either take the home sleep study kit with you or have an in-lab study booked. Results are back in 48 to 72 hours. The second appointment is where you sit down with your AHI on paper and leave with a written treatment plan, not another referral, not a vague recommendation.
CPAP starters come back at four weeks. Everyone returns at three months. A repeat sleep study at six months gives us the numbers to confirm the treatment is working.
Frequently Asked Questions
Which doctor treats sleep apnea, an ENT or a pulmonologist?
Both, and ideally in the same conversation. Upper airway (nose, palate, tongue base, tonsils): ENT. Lower airway, oxygenation, sleep medicine: pulmonologist. The problem with seeing them weeks apart is that neither reads the other's notes. You get two plans built on half the picture. ENT vs pulmonologist for sleep apnea has the fuller breakdown.
Does insurance cover sleep apnea treatment?
Depends entirely on the insurer and the paperwork trail. In-lab polysomnography and CPAP titration are usually covered when the clinical indication is properly documented. Most group and government plans include this. The CPAP machine itself is a different story: insurers classify it as durable medical equipment, and reimbursement varies widely. Home sleep studies often fall through the gap too. We prepare the ICD-10 codes and itemised bills you need. Read your policy's sleep medicine and DME clauses before the test, not after.
How much does a sleep study cost in Hyderabad?
The home study is the cheapest starting point. It typically runs ₹2,400 to ₹5,000 in Hyderabad. In-lab polysomnography costs more, usually ₹6,500 to ₹12,000 depending on the centre. DISE is billed separately as a day-care procedure when it is needed. Full pricing is on the sleep study cost Hyderabad page.
How long does it take to feel better with CPAP?
Faster than most people expect. Most patients notice clearer mornings within one to two weeks of consistent use (four or more hours per night). Daytime sleepiness on the Epworth scale typically drops within a month. Blood pressure, mood, and concentration take two to three months to shift.
The catch is the four-hour rule. Under four hours a night, you are not getting the benefit.
Can sleep apnea go away on its own?
Rarely, and only if the underlying cause changes. Significant weight loss, treatment of nasal obstruction, or correcting a positional pattern can bring AHI down enough that some patients come off CPAP. Mild positional OSA is the most reversible. Moderate and severe OSA do not resolve without active treatment.
Is there a way to treat sleep apnea without wearing a mask every night?
For mild to moderate OSA, yes. Mandibular advancement devices, positional therapy, weight reduction, and DISE-guided surgery are all real options with clinical evidence behind them. For severe OSA, CPAP or BiPAP is still the most reliable treatment. We go through the alternatives in detail before recommending any single path.
Book Your Sleep Assessment
Untreated sleep apnea is not just snoring. It compounds cardiovascular risk over years, and the only way to know your AHI is to measure it. A sleep assessment at Respire takes one consultation and one night of sleep at home.
Book your appointment at Basheer Bagh or Jubilee Hills, Hyderabad.
All consultations are strictly confidential. No referral is needed.
Related reading
7 Signs You Have Sleep Apnea (Not Just Snoring)
Most people think sleep apnea just means loud snoring. It doesn't.
The Hidden Connection Between Sleep Apnea and Blood Pressure
Half of all sleep apnea patients have hypertension. If your blood pressure is hard to control despite medication, sleep apnea may be why. Here is the science.
CPAP vs BiPAP vs APAP: Which One Do You Need?
Your doctor has recommended PAP therapy. But there are three different options available: CPAP, BiPAP, and APAP. You may not know which one is right for you.