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Snoring and Obstructive Sleep Apnoea

Obstructive Sleep Apnoea (OSA) is a serious condition in which the airway repeatedly collapses during sleep, interrupting breathing dozens or hundreds of times a night.

The consequences are not confined to tiredness. Untreated OSA is associated with high blood pressure, cardiovascular disease, stroke, type 2 diabetes and a significantly increased risk of road traffic accidents. It is also very treatable, which is why it is worth identifying.

SYMPTOMS WORTH ACTING ON

  • Loud snoring, particularly if witnessed pauses in breathing occur
  • Unrefreshing sleep despite adequate hours in bed
  • Excessive daytime sleepiness — falling asleep watching television, in meetings or, critically, while driving
  • Poor concentration, irritability or low mood
  • Frequent waking to pass urine at night
  • In children: snoring every night, restless sleep, mouth-breathing, bedwetting, poor growth, or behavioural and attention difficulties often mistaken for other conditions

ASSESSMENT

Assessment begins with a full history — including, where possible, an account from your bed partner, who often reports what you cannot — and validated questionnaires such as the Epworth Sleepiness Scale and STOP-BANG.

Examination identifies the level of obstruction: the nose, the palate and tonsils, the tongue base, or a combination. Flexible upper airway endoscopy, performed in clinic through the nose, is used to inspect the upper airway directly.

Where OSA is suspected, a sleep study is arranged. This measures breathing, oxygen levels and sleep quality overnight and establishes whether apnoea is present and how severe it is. Many studies can now be performed at home rather than in a laboratory.

TREATMENT

Treatment is matched to the severity of the condition and the site of obstruction.

  • Conservative measures — weight reduction where relevant, positional therapy, alcohol and sedative avoidance, and treatment of nasal obstruction, which alone can transform symptoms in some patients
  • Continuous Positive Airway Pressure (CPAP) — the most effective treatment for moderate and severe OSA in adults, delivered through a mask worn overnight
  • Mandibular advancement devices — custom dental appliances for snoring and mild to moderate OSA
  • Nasal surgery — septoplasty, turbinate reduction or sinus surgery to relieve nasal obstruction, which frequently also makes CPAP tolerable for patients who could not previously use it
  • Palatal and tonsillar surgery in selected adult cases
  • Adenotonsillectomy in children, which is the first-line treatment for paediatric OSA and is curative in the large majority

WHEN TO SEEK AN OPINION

Book an assessment if you snore loudly most nights, if anyone has witnessed you stop breathing during sleep, if you feel sleepy during the day despite sleeping enough, or if your child snores every night.

Request an appointment: +357 24 840840