Snoring comes in a number of forms but can certainly create problems. Primary snoring describes a situation where snoring occurs without any other health consequences. It is annoying for the person and anyone close enough to notice but consequences are usually limited.
Sleep apnoea refers to the situation where a person stops breathing or is unable to breathe adequately while asleep. This is usually witnessed as laboured breathing or a long pause in breathing followed by a “catch-up” snort or sudden breath. In some instances, it can wake the person and, in severe cases, can occur hundreds of times a night. Usually the person experiences a restless night and wakes the following morning feeling unrefreshed. Sufferers are often tired through the day and may fall asleep at inopportune times. Sleep apnoea has been linked to behavioural problems and poor performance in children at school. Adults may experience concentration issues and it can be a contributing factor in motor vehicle and workplace accidents.
The causes of sleep apnoea are varied but it is often due to a number of inter-related factors. There can be physical factors such as large tonsils, floppy throat tissues, nasal blockage and obesity. Additionally, there can be problems related to the way a person’s brain regulates breathing and general issues related to sleep behaviours.
Most people with sleep apnoea snore and typically do so loudly. They can complain of:
- Loud snoring.
- Restless sleep.
- Witnessed pauses in breathing (apnoeas).
- Daytime tiredness.
- Poor concentration.
- Morning headaches.
Sleep apnoea may be suspected based on the symptoms, personal experiences and the observations of a person’s loved ones.
The reason for sleep apnoea can sometimes be determined via an examination of the head and neck region to identify physical factors that may contribute. In some cases, a sleep study test is helpful in confirming the problem and will aid in the development of a solution.
The treatment of children and adults with “sleep apnoea” differs. Children tend to benefit from surgery to remove the tonsils and adenoids and in some case to address the nose. Most recent studies on this topic indicate successful treatment of sleep apnoea in 90% or more children with this intervention. Hence, often children with sleep apnoea will be offered and will benefit from surgical intervention.
Adults are less likely to benefit from surgery. This is because adults usually have multiple factors contributing to the problem and surgery doesn’t always have the capacity to address all of those factors. In some instances, the use of special splints for the mouth, weight loss and the use of a Continuous Positive Air Pressure (CPAP) machine may be advised.
In selected circumstances where there is a clear physical issue such as a blocked nose or large tonsils, adults may be offered and benefit from surgery. There may be a need for sequential operations to address specific anatomic contributors to the sleep apnoea due to the multi-factorial nature of the problem. Ultimately this can be a complicated decision-making process and Dr Morrissey and other ENT surgeons are well trained in assessing the situation.