Snoring & Obstructive Sleep Apnoea (OSA)
Snoring is an unpleasant, and in the majority of times loud noise, produced during sleep by turbulent flow of air.
The turbulence is produced if there is narrowing or a blockage through the nasal passages, the back of the soft palate and uvula, the base of tongue and rarely, the laryngeal inlet.
Obstructive Sleep Apnoea (OSA) is snoring interrupted by frequent episodes of totally obstructed breathing.
These serious episodes last more than ten seconds and can occur between 30 – 300 times per night.
Obstructive Sleep Apnoea events lower blood oxygen levels, causing strain on the heart.
Muscles can tense in order to keep airflow to the lungs; this can result in patients feeling tired and sleepy during the day and having interrupted sleep at night. The performance of the person in day to day activities is reduced and the impact in the life quality is significant.
The commonest causes of snoring and/or OSA in children are:
- Enlarged tonsils and adenoids
- Nasal allergy with enlarged adenoids
Commonest causes of snoring and / or OSA in adults are:
- Nasal septal deviation
- Nasal polyps
- Long uvula and lax soft palate
- Enlarged tonsils
- Obstruction at the back of the tongue
Treatment for OSA is mainly:
- significant weight loss
- exercise and
- CPAP (the use of a device that provides oxygen via a nasal/face mask during sleep given by a respiratory physician following a sleep study)
Treatment for snoring, when weight loss and exercise do not improve the symptoms, is mainly surgical.
Nasal Surgery. For nasal conditions, a septoplasty or endoscopic polypectomy is needed.
Palatal Surgery. This is very frequently used in addressing the problem of snoring, as the palate is the most usual level of obstruction. Palatal surgery may involve just the uvula and soft palate (uvulo-palato-plasty) or a more extensive procedure reshaping the uvula, soft palate and removing the tonsils (uvulo-palato-pharyngoplasty).
Tongue Surgery. For obstruction at the back of the tongue, a mandibular advancement device (splint) can be used. Also, radio-frequency is used to reduce the size of the back of the tongue under general anaesthesia.