Assessment and Treatment of Snoring
Snoring and sleep apnoea (temporary cessation of breathing during sleep) can be very intrusive and debilitating conditions. Causes of these conditions can include nasal blockage, from deviated nasal septum, polyps, and Adenoid enlargement; obstruction of the throat, from enlargement of the tonsil, large and floppy tongue, cysts in the throat and a collapsing throat. Obesity can also contribute to these problems. Body structure may influence these symptoms. Short stature with a thick set, short neck may predispose to snoring and sleep apnoea.
Having taken a thorough history of the problem, I will carefully examine the patient and pass an endoscope/camera into the nose and assess the nasal channels, inspect for enlarged tonsils or adenoids and assess patency of the throat. It maybe necessary to arrange a CT scan of the nose and sinuses to assess the cause of the problems.
I will next arrange for the patient to have sleep studies performed. These can usually be performed in the patient’s home and an assessment is made of the sleep pattern over-night, with a variety of different observations being made. I will also perform a flexible nasopharyngolaryngoscopy under controlled sedation. This procedure is performed as a day-case. My anaesthetist will administer the patient an intra-venous sedative and the patient will sleep and breathe normally. I will then pass an endoscope into the nose and throat and perform a dynamic study, looking at movements in the throat. I will particularly look for abnormal collapse of the throat on breathing in or out. These assessments will help me to decide the nature of the problem and tailor an appropriate treatment for the patient’s requirements.
Sometimes surgery will then be recommended in the form of a Septoplasty, Tonsillectomy, Nasal Polypectomy or Uvulopalatopharyngoplasty (tightening of loose tissues in the upper throat). Conservative treatment including arranging the fitting of a CPAP (continuous positive airway pressure) breathing device or a MAD (Mandibular Advancement Device) maybe recommended. The treatment will be custom made to suit the individual’s medical needs.
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