Significant snoring, especially in people over 50, often indicates Hypoxia (low oxygen levels). This can lead to severe memory issues, anger problems, and poor metabolic control. It is often a sign of Obstructive Sleep Apnea (OSA) which requires medical evaluation via a Polysomnography (Sleep Study).

If you haven't seen improvements in sleep quality, mood, or weight loss within 2 months of initiating CPAP therapy, your treatment plan needs modification. Dr. Tony specializes in CPAP/BiPAP titration to ensure the therapy is effective for you.

Yes, we have a specialized Pediatric Pulmonology division. We treat childhood asthma, allergies, pediatric sleep problems (like snoring/mouth breathing), and recurrent infections. Early diagnosis in childhood can prevent long-term complications.

We perform Skin Prick Allergy Testing to identify specific triggers such as environmental factors or food exposures. Identifying and eliminating these triggers helps reduce disease exacerbations and the need for steroids. Immunotherapy is also available for long-term control.

Simple lifestyle changes can help:

• Avoid white LED lights in bedrooms; use warm yellow bulbs.
• Reduce water intake after 6 PM to prevent night urination (unless advised otherwise for CKD/Heart Failure).
• Limit screen time (mobiles/TVs) before bed to reduce stress and aid natural sleep cycles.

• Age of Onset: Asthma can start in childhood or adolescence, whereas COPD is never seen in the younger population.
• Symptoms & Treatment: Both cause similar breathing difficulties and are relieved using similar medications like inhalers, tablets, nebulization, and injections.
• Triggers: Allergy is usually a trigger for most asthma attacks, while allergy rarely triggers a true allergic COPD attack.
• Management: Both are to be treated with appropriate medications like inhalers, nebulizations, but additionally can improve further with breathing excercises.
• Long-term Outlook:Vaccinations can reduce severity of infective exacerbations & related need for hospital or icu level treatment
• Side Effects: To avoid side effects from steroidal inhalers, always gargle and spit after use.

No addiction is seen usually. Inhalers can be stopped immediately if the condition is manageable on oral medications.

Inhalers are designed for long-term use with minimal side effects because 85-90% of the inhaled molecules reach the actual working site (the lungs) directly. In contrast, with tablets, only around 5-10% actually reach the lungs. Because the dose is lesser, side effects are lesser, making inhalers a better option.

Yes. Once you are feeling better on the correct inhalation medication, I advise slowly adding deep breathing exercises for the chest cage muscles and pullover rows to improve the accessory muscle power.

• Food: Heavy or spicy foods at night can cause cough. Reduce those foods and replace them with oats porridge or ragi kuruku. Eat dinner compulsorily adding raw cucumbers, carrots, or beetroot to reduce gastric acidity.
• Bed Mites: Can trigger cough during sleep. Put the mattress in the strongest sunlight possible and deep clean it.
• Dust: Dust on fan blades can trigger cough; wipe down the fins. Clean curtains at least once a month.
• Temperature: Keep ACs at 27°C throughout the night and keep windows closed to reduce cold-induced cough.
• If your nose gets blocked/runny and the cough starts, get a Skin Prick Allergy Test done to find the exact allergen.

Please don't exercise just to 'test' your condition.

• Use your inhalers & medications exactly as advised BEFORE the exercise activity.
• Indoor Gyms: Don't exercise directly in front of AC vents; the cold can trigger an attack.
• Safety: Always tell the Main Gym Trainer that you have Exercise-Induced Asthma and where you keep your inhaler. Always have a backup inhaler at hand.
• Hydration: Don't drink ice-cold water during exercise.
• Outdoors: If exercising in gardens/parks, get an SPT done to avoid plant allergies. Avoid environmental triggers on the way to the gym.
• Ensure you don't have Obstructive Sleep Apnea (OSA), which can make breathing a bigger struggle during exercise.

Yes. There is ONLY ONE TEST in the whole world to DIAGNOSE Sleep Apnea: POLYSOMNOGRAPHY (Sleep Study).

If you or your partner notice snoring, disturbed sleep, sudden waking, anger issues, or forgetfulness, a sleep study is mandatory. Always prefer home sleep study screening if possible for a more natural sleep recording.

Note: Before the test, get GERD under control, treat allergies/sinusitis, and avoid sleep meds (like Cetirizine or Melatonin) and daytime naps on the day of the study.

• CPAP (Recommended): Cost-effective, no pain, no suffering. It is only used during sleep, and users often gradually lose weight with exercise.
• Bariatric Surgery: Reduces food consumption and weight drastically. Cons include pain, hospital expenses, immobility, drastic food pattern changes, and rare risks like embolism or infection.
• Throat Surgery: Can be done to remove thickened tissues in pharyngeal walls for immediate relief of snoring and gasping.

Yes, 100%. Just 4-8 kgs of weight loss can significantly cure your Sleep Apnea. Weight loss should be the main agenda for any OSA Treatment Plan.

Yes. When you sleep, your heart and body must relax completely to recover. With sleep apnea, you never get good quality sleep due to snoring, hypopneas, apneas, and most importantly, the drop in oxygen supplying your organs.

Because of this, the brain wakes you up to breathe, and your heart pumping increases to improve blood flow. This causes higher cardiac stress during sleep. Consequently, the deeper you sleep (e.g., after alcohol or sleeping pills), the higher the risk of a dangerous cardiac event.

Generally, with good local anesthesia and IV sedation, pain should never be felt during a routine bronchoscopy.

• Flexible Bronchoscopy: Can be done with good deep sedation. If procedures like TBNA/TBLB are attempted, muscle relaxants may be added.
• Rigid Bronchoscopy: This requires full general anesthesia.

Generally, a pleural biopsy or thoracoscopy is done after creating a small hole in the chest wall to access the inside of the rib cage, so 2 to 3 days is typically required for recovery.

Yes, all interventional procedures have a varying element of risk depending on the route of access, the area being sampled, the procedure type, and the patient's health (including comorbidities like cardiac conditions).

However, these procedures are usually done to "save lives," and they save more lives than cause harm. The specific risk-benefit ratio will be described to you by the treating pulmonologist before the procedure.

All pets can cause allergies. Ideally, you should test for allergies before investing in a pet.

If you or your family members have persistent new allergic symptoms that align with the timeline of getting the pet, you can get a skin prick test done. If positive, immunotherapy can often solve the problem. If immunotherapy doesn't work, then rehoming the pet is the best solution.

Vaccinations are a vital part of comprehensive lung care. The purpose is to reduce infection severity and avoid lung damage (viral pneumonia), though you may still get a mild fever.

• Influenza: Adults over 50 should compulsorily get the latest VAXIFLU TRIVALENT as a single deep intramuscular injection once a year.
• Pneumococcal: Recommended for smokers and patients with COPD, Asthma, ILD, Bronchiectasis, chronic cardiac, renal, or hepatic conditions.
  Protocol: Inj Prevenar 20 followed in a year by Inj Vaxiboon (Deep IM), once every 5 years.

All are also recommended for Oncology patients

Cough for more than 8 weeks is called chronic cough.

The following are basic diseases to be ruled out based on the detailed history of the patient:

• Atypical infections, Cough variant asthma, Allergic cough
• GERD, Post Nasal Drip, Exercise induced cough
• Tuberculosis, IPF, ILD, Sarcoidosis
• Malignancy, carcinoids in the airway
• Foreign body aspiration
• Medicines like Ramipril, Enalpril, Lisinopril

Dr. Tony consults at KIMSHEALTH Kottayam (Mon, Tue, Wed, Fri, Sat), Vimala Hospital (Tue & Thu), and Manak Hospital (Wednesdays). You can book an appointment by calling +91 97460 30499 or using the online booking form.