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Snoring and Sleep Apnoea

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Snoring is extremely common, affecting about 40% of men and 25% of women.  It is caused by the vibration of the soft palate (the roof of the mouth), the tonsils and the base of the tongue, which occurs when our muscles are relaxed whilst asleep.  When it is severe, it can cause disturbed sleep for the snorer and their partner.  

 In some patients, the obstruction can be so severe that blood oxygen levels in the blood can fall periodically during the night.  This is a condition known as obstructive sleep apnoea (OSA), which may cause poor quality sleep, tiredness during the day, and strain on the heart.

What causes snoring?

There are many causes of snoring and OSA, and there is often more than one cause in any single patient.  Snoring becomes more and more common as we get older.  Snoring and OSA are also more common in those who are overweight.  Alcohol, and drugs that cause sedation, can make snoring more severe.

Snoring is often caused by the vibration of tissues in the throat and upper airway during sleep.In some patients, there may be structural problems with the nose and throat that can contribute to their snoring or OSA, such as large tonsils, a low-hanging soft palate, or a poor nasal airway due to inflammation, nasal polyps or a deviated nasal septum.

What is obstructive sleep apnea (OSA)?

Obstructive sleep apnea is a sleep disorder characterized by repetitive episodes of partial or complete blockage of the upper airway during sleep. This obstruction leads to interrupted breathing and disrupted sleep patterns.

How do I know if I have sleep apnea?

Common signs of sleep apnea include loud and chronic snoring, excessive daytime sleepiness, morning headaches, restless sleep, waking up gasping or choking, and difficulty concentrating. If you suspect sleep apnea, it is important to consult an ENT surgeon for a proper evaluation.

Can snoring be a symptom of sleep apnea?

Yes, snoring can be a symptom of sleep apnea, especially if it is loud, disruptive, and accompanied by other symptoms like gasping for air during sleep.

How is snoring and sleep apnea diagnosed?

ENT surgeons often collaborate with sleep specialists to diagnose snoring and sleep apnea. A sleep study, either in a sleep laboratory or through a home sleep test, is typically conducted to monitor various parameters during sleep and determine the presence and severity of sleep apnea.

What treatment options are available for snoring and sleep apnea?

Because there are many causes of snoring and OSA, the treatment can be complex.  There is often no “magic bullet” treatment that will completely cure a patient’s snoring or OSA; however it can be improved with a combination of lifestyle, medical, and sometimes surgical interventions.

Some examples include:

  1. Lifestyle modifications – Weight loss, avoid alcohol before bedtime, Exercise
  2. CPAP therapy (the gold-standard treatment for moderate/severe OSA)
  3. Sleep position modification
  4. Medical treatment to treat rhinitis or chronic rhinosinusitis
  5. Surgical treatment to improve nasal airway, e.g. septoplasty
  6. Jaw splints / mandibular advancement devices
  7. Removal of enlarged tonsils
  8. Surgery to reduce palate length
  9. Radiofrequency treatment to the palate/tongue base

With so many treatment options, it is important to be examined and investigated by a specialist so that a treatment plan can be tailored to your specific needs.

What surgical options are available for sleep apnea?

ENT surgeons can offer surgical interventions to address structural abnormalities that contribute to sleep apnea, such as uvulopalatopharyngoplasty (UPPP), tonsillectomy and adenoidectomy, nasal surgery, and in some cases, maxillomandibular advancement surgery. These procedures aim to widen the airway and improve airflow during sleep.

Is surgery the only solution for sleep apnea?

Surgery is not always the first-line treatment for sleep apnea. Depending on the severity and individual circumstances, lifestyle modifications, CPAP therapy, or oral appliances may be effective in managing the condition. Surgical intervention is usually considered when conservative measures have failed or in specific anatomical cases.

Can children have sleep apnea?

Yes, sleep apnea can affect children as well. Common causes in children include enlarged tonsils and adenoids, obesity, and craniofacial abnormalities. If you suspect sleep apnea in your child, it is crucial to consult an ENT surgeon experienced in pediatric sleep disorders.

Can snoring and sleep apnea be cured?

While there is no definitive cure for sleep apnea, effective treatment can significantly improve symptoms and quality of life. With proper management, including lifestyle modifications, appropriate therapies, and surgical interventions when necessary, snoring and sleep apnea can be effectively controlled and managed.

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