Snoring & Obstructive Sleep Apnoea

written by Dr Yeo Sek Wee on 9 May 2013

All About Snoring -

 
Snoring is a nuisance to sleeping partners and can lead to considerable tension in a relationship.
 
Unfortunately, snoring can be associated with sleep apnoea, which has some serious consequence such as hypertension, stroke, heart problems and daytime lethargy.
 
Snoring is due to vibrations that occur in the throat during inspiration because the muscles of the plate and throat relax during sleep.
 
Sleep apnoea occurs when the upper respiratory system collapses, causing obstruction. The obstruction persists until the level of sleep lightness, allowing muscle tone to increase, which in turn overcomes the obstruction allowing passage of air into the lungs. During the period of obstruction, the oxygen concentration in the blood decreases, while carbon dioxide builds up. The cycle of breathing and obstruction continues throughout the night causing ineffective sleep so that during the day is considerable tiredness and lethargy with lack of concentration and co-ordination.
 
Drowsiness when driving because of the interrupted sleep may cause the driver to fall asleep at the wheel and have an accident.
 
These are questions we ask patients
 
How loud is the snoring?
 
Does it occur every night?
 
Does it occur in all sleeping positions?
 
Does breathing stop?
 
Is there daytime lethargy?
 
Does driving bring on drowsiness?
 
Is the nose blocked?
 
What medications is the person taking?
 
How much alcohol is consumed?
 
It Is important that partners are present at the time of the interview, as they provide important information e.g. the severity  of the snoring; does it occur in all sleeping positions, or solely when lying on the back; is sleep  apnoea present, and how frequently does it occur.
 
When we examine a snoring patient, we are looking for:
 
Whether the patient is overweight.
 
If nasal obstruction is present.
 
If size of the tongue.
 
If the tonsils are large.
 
The thickness of the palate and the size of the uvula.
 
After the history is taken and the patient examined, we then arrange for them to have a sleep study. This entails staying overnight in a sleep Study Unit, so that observations can be made as to the severity of the snoring and whether obstructive sleep apnoea is present.