Patient Guide

Snoring and Obstructive Sleep Apnoea

Snoring is noise produced during inspiration when one is asleep.

It is due to the vibration of the soft palate , uvula base of tongue and other soft tissues in the throat when one inhales. Snoring implies an increased resistance to the inflow of air during breathing at this level of the upper airways.

As much as 30% of the adult population, or 60% of over aged 40 or more.

Is snoring an illness?

Snoring itself is not an illness, but it can be a potential problem, especially if it disturb other people's sleep.

Snoring if associated with symptoms of tiredness, poor concentration, daytime sleepiness, choking sensation at night, may be a potential serious medical problem - Obstructive Sleep Apnoea (OSA).

Diseases associated with OSA

  1. Obesity
  2. Hypertension
  3. Ischaemic Heart Disease
  4. Stroke (Cerebrovascular Accidents)
  5. Diabetes Mellitus

Symptoms of OSA during the day:

    • Daytime sleepiness, tiredness
    • Poor concentration
    • Poor memory
    • Morning headaches
    • Mood changes
    • Irritability

    During the night

    1. Choking sensation at night
    2. Gasping for air at night
    3. Frequent arousals from sleep
    4. Nocturia (frequent passing of urine)
    5. Loud snoring

    What is Obstructive Sleep Apnoea (OSA)

    OSA is a disorder that is characterized by repetitive episodes of airway obstruction that occur during sleep, and usually associated with snoring and reduction in blood oxygen saturation. Apnoea is defined as an absence of airflow for 10 seconds or longer.

    Severity of OSA is measured in terms of the number of apnoeaic episodes per hour over a night's sleep. A "normal" Apnoea-Hypopnoea Index (AHI) is generally considered to be less than 5. Some patients with severe OSA, e.g AHI >40, can stop breathing as often as once every minute, over the enire night's rest.

    Diagnosis of OSA requires a thorough clinical examination, and a flexible nasendoscopy. An overnight sleep study (polysomnogram) is also mandatory.

    Treatment of OSA

    • Conservative measure
    • Weight loss
    • Sleep on the side
    • Stop smoking
    • Avoid being deprived
    • Avoid alcohol, sedatives
    • Regular exercise

    Medical Treatment

    Nasal Continous Positive Airway Pressure (CPAP)

    This is a non-evasive method of treatment, it entails using continous positive airway pressure by a nasal clip worn by the patient throughout the night. CPAP is the most effective and frequently used treatment for OSA, but the issue of compliance is a major problem.

    Oral Appliances (OA)

    These are mouthpieces that are worn while sleeping to prevent the airway from collapsing.

    Surgical Treatment

    Surgical management by OSA has become more established these recent years. Surgical treatment has been shown to be effective and curative in certain subset of patients.

    Surgical correction ranges from reduction of the soft palatal redunduncy to skeletal surgry by jaw advancement.

    Surgical moments

    1. Somnoplasty
    2. Uvulopalatopharyngoplasty
    3. Laser assisted uvoplasty
    4. Nasal submucous diathermy
    5. Palatal advancement
    6. Tongue base reduction
    7. Genioglossus advancement
    8. Maxillomandibular advancement

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