Snoring, when associated with choking, unrefreshing sleep or daytime sleepiness, can be a symptom of obstructive sleep apnoea. The Department of Otolaryngology at Singapore General Hospital (SGH) discusses its causes and treatment options.
What is obstructive sleep apnea?
A symptom of
obstructive sleep apnea (OSA) is snoring associated with choking, unrefreshing sleep, daytime sleepiness or fatigue. This is a condition where there is repeated upper airway collapse during sleep. This causes breathing to stop and the brain needs to wake up temporarily to open the airway to breathe again before falling back to sleep. On returning to sleep the obstruction occurs again and this cycle repeats. This causes poor sleep quality.
Treatment of sleep apnea
Positive Airway Pressure (PAP)
The most common way of delivering it is CPAP (continuous positive airway pressure). PAP is positive pressure delivered by a machine that blows out air and is connected to a mask (via a hose) worn during sleep. This column of air pressure prevents the airway from collapsing.
Dental splints
Dental splints are devices (also worn during sleep) that protrude the lower jaw by keeping the lower teeth in a more forward position. By maintaining the lower jaw in a protruded position it enlarges the air space behind the tongue and puts the air passage tissues in greater tension. This decreases the tendency for the airway walls to collapse.
Surgery
Performed on the areas (eg, soft palate) that contribute to narrowing in the air passage. Surgery works by repositioning or removing tissues in or around the airway to enlarge it. Besides surgery done under general anesthesia, there are also minimally invasive surgical procedures like Pillar Implants and a radio frequency treatment that can be performed under local anesthesia. But these procedures are more effective for simple snoring and mild obstructive sleep apnea.
Causes of sleep apnea
-
Abnormal shape of the facial bones, inherited or developed over time (this may include nasal problems that narrow the nose passage).
- Tonsils
- Adenoid enlargement
- Obesity
- Increasing age (when tissues in the air passage become more lax).
The Otorhinolaryngology - Head and Neck Surgery department at Singapore General Hospital (SGH), a member of the
SingHealth group, offers a complete range of ENT clinical and paraclinical services dealing with problems of the ear, nose and throat. Services include rhinology/endoscopic sinus surgery, head and neck surgery, otology/neuro-otology, voice disorders, sleep apnea surgery and paediatric otolaryngology. The
Sleep Disorders Clinic adopts a multi-disciplinary approach in the treatment of sleep disorders, with specialists from Respiratory Medicine, ENT, Neurology as well as Psychologists and Psychiatrists.
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here for a more detailed explanation with visual diagrams.
Ref: W09
