Sleep Apnea

The Problem

If you snore, first of all you should not rule out that you may suffer from a more serious health condition called sleep apnoea. It is more commonly known by the US spelling - apnea.

People with sleep apnea actually stop breathing for brief periods of time (usually 10-20 seconds) whilst asleep.

Sleep apnea often results in feelings of excessive tiredness during the day and the ability to reach deep, restorative sleep stages is impaired. Other warning signs of sleep apnea are often noticed by bed partners and include loud snoring and making snorting or choking sounds at night.

There are three types of sleep apnea, Central Sleep Apnea (CSA), Obstructive Sleep Apnea (OSA), and Mixed Sleep Apnea ( i.e. both Central Sleep Apnea and Obstructive Sleep Apnea).

1. What is Central Sleep Apnea and what causes it?

Central Sleep Apnea (CSA) occurs when the brain does not send the signal to breathe to the muscles related to our breathing.

This usually occurs in adults with heart disease, cerebrovascular diseases or congenital diseases but also can be caused by some medications and high altitudes. In adults with Central Sleep Apnea, the apneas are usually resolved by treating the underlying heart disease, medication interaction, high altitude, or other primary problem.

If you suffer from CSA you should visit your GP as soon as possible. Our treatments are aimed at reducing your snoring and will not be able to improve your condition in cases where Central Sleep Apnea is the diagnosis.

2. What is Obstructive Sleep Apnea and what causes it?

This is the most common category of sleep disordered breathing.

Obstructive Sleep Apnea (OSA) is estimated to affect 4% of men and 2% of women respectively. It is probably even more prevalent as the population is becoming more obese as obesity worsens Obstructive Sleep Apnea.

An Apnea event has four components.
1. First, the airway collapses.
2. Second, an effort is made to take a breath, but is unsuccessful.
3. Third, the oxygen level in the blood drops.
4. And when the amount of oxygen reaching the brain decreases, the brain signals the body to wake up and take a breath. (This is what the bed partner hears as a silence followed by a gasp for air.)

Airflow can become diminished for a variety of reasons:

  • If a person has a deviated septum.
  • If the palate and uvula (the piece of skin that hangs in the back of your throat) are long or floppy, they can fall backwards and close the area for breathing.
  • The back of the tongue can also fall backwards and obstruct breathing especially when laying flat on your back.
  • Finally the side walls of the throat can fall together to narrow or close the airway.

Please note that our treatments are aimed at reducing your snoring and freeing your airway and are suitable only in case of obstruction due to a blocked nose or an enlarged uvula.

What are the symptoms of Obstructive Sleep Apnea ?

Common symptoms include loud snoring, restless sleep, and sleepiness during the daytime. Sleep Apnea causes high blood pressure and sufferers have a 30% higher risk of heart attack. Unfortunately it is estimated that only 10% of people with Obstructive Sleep Apnea seek medical attention.

The Treatment 

At The Private Clinic, during your consultation, we will perform a medical assessment and will help you to complete an Epworth questionnaire to assess whether or not you may be suffering from sleep apnea and to assess the severity of your condition.

Laser Assisted Uvulopalatoplasty (LAUP)

A simple procedure performed under local anaesthetic to target the excess vibration of the soft palate and uvula (the stalactite of flesh at the back of the throat). The patient sits in a chair as if at the dentist whilst the ENT Surgeon uses a laser to remodel the excess vibrating soft tissue at the back of your throat. LAUP is a long established procedure in the UK with over 20,000 procedures performed to date.

Bipolar Radiofrequency Thermotherapy (RFITT)

A radio frequency treatment to tighten the muscle within the soft palate causing less vibration during sleep. The procedure involves numbing the back of the throat with a local anaesthetic and targeting it with a slim pen that emits a high frequency. The heat causes the muscle to tighten – which it continues to do so in the weeks following treatment, with the maximum benefit being achieved after six months.

Unblocking the nose

The nasal cavity can sometimes be obstructed by swelling of the turbinates and septal deviation. At The Private Clinic we use a minimally invasive procedure to reduce enlarged fleshy ridges or ‘turbinates’ at the entrance of the sinuses or to correct a deviated septum (a buckled partition between the two nostrils). Nasal obstruction makes CPAP difficult if not impossible to tolerate. Surgery to open the nasal passages markedly improves tolerance to CPAP.

Sleep Apnea can be a very serious condition. If you are a loud snorer, you may suffer from Sleep Apnea.

FAQs

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  • Are there any other non-surgical treatments for obstructive sleep apnea?

    Some treatments involve lifestyle changes, such as avoiding alcohol or muscle relaxants, losing weight, quitting smoking or changing sleeping position.

    Some people require the use of a breathing machine called CPAP – continuous positive airway pressure. CPAP delivers the air through a nasal or face-mask under pressure. When adjusted properly and tolerated, it is nearly 100% effective in eliminating or reducing obstructive sleep apnea. Unfortunately only 60% of people with CPAP machines report that they use them and only 45% of them actually use them more than 4 hours per night.

    The use of CPAP mask can be impaired when a patient has nasal congestion or a septal deviation; it is important to have these evaluated since they can be treated (see above under surgical treatments).

    Another non-surgical method is a dental appliance to hold the jaw, keeps the tongue forward and holds the palate up thus preventing closure of the airway. This small increase in airway size sometimes is enough to control the apneas. A dental appliance requires natural teeth to fit properly and it must be worn every night.

    Finally many medications have been studied for obstructive sleep apnea; however, because obstructive sleep apnea is due to an anatomic airway narrowing, it has been difficult to find a medication that will help.

  • What are the surgical treatments for obstructive sleep apnea

    There are many surgical options to treat obstructive sleep apnea. The type of surgery that is chosen is dependent on an individual’s specific anatomy and severity of sleep apnea.