Obstructive Sleep Apnoea

Obstructive sleep apnoea (OSA) is a condition in which the soft tissues of the throat, including the tongue, collapse during sleep. This blocks the upper part of the airway. It obstructs and can stop air flow. It causes sleep disturbance which may include daytime sleepiness and poor concentration.

 

Causes:
osa-edit

Click image to enlarge.

 

Obesity is one of the most common causes of sleep apnoea. A loss of around 5kg to 10kg may be enough to dramatically reduce the severity of the disorder. Other contributing factors include: Alcohol, especially in the evening – this relaxes the throat muscles and hampers the brain’s reaction to sleep disordered breathing. Large tonsils especially in children and nasal congestion are also contributing factors. Alcohol and overeating before bedtime can make the problem worse. Nasal obstruction can contribute to obstructive sleep apnoea but is not the only cause of obstructive sleep apnoea.

 

 

 

 

Medical Symptoms:

 

Daytime sleepiness, waking up poorly refreshed, micro sleeps, falling asleep at traffic lights. Severe OSA can lead to cardiovascular complication risk to long term health problems.

Obesity is one of the most common causes of sleep apnoea. A loss of around 5kg to 10kg may be enough to dramatically reduce the severity of the disorder. Other contributing factors include: Alcohol, especially in the evening – this relaxes the throat muscles and hampers the brain’s reaction to sleep disordered breathing. Large tonsils especially in children, nasal congestion and nasal obstruction. Alcohol and overeating before bedtime can make the problem worse.

 

Medical Treatment:

 

1. The use of CPAP (Continous Positive Airway Pressure Machine). This is a machine worn at night whilst asleep delivering positive pressure to the upper airways.

 

2. A mandible advancement device or mouth guard can also be used to treat snoring and sleep apnoea. The aim is to stabilise the tongue whilst sleeping and to advance the lower jaw forward.

 

3. Surgical treatment in the majority of cases involves correction of nasal obstruction as well as surgery to the throat and tongue. Nasal surgery usually includes turbinate reduction as well as septoplasty or septorhinoplasty. Nasal polyps may also have to be removed if present. Surgery to the throat and tongue is performed in suitable cases. Using an advanced technique called coblation. Coblation involves reduction of the bulk of the tongue base as well as stiffening the palate. Removal of large tonsils and reshaping the soft palate is also performed. Patients who wish to seek surgical treatment for snoring and sleep apnoea need to be properly assessed prior to making any decision. Ideally tests should be performed in conjunction with the patients sleep physician and ENT surgeon.

 

Dr Ananda conducts a combined sleep clinic at Concord Hospital on a monthly basis. Success rates up to 80% can be achieved by surgical treatment in suitable cases.