‘What’s Up Doc’ is a health column in association with The Crawley Observer, which gives you the opportunity to ask questions regarding general health and wellbeing.
Answers are provided weekly from our specialist consultants at Spire Gatwick Park Hospital, Surrey. If it’s a long-standing illness or simply a worry which you would like to get off your mind then we would like to help.
This question appeared in The Crawley Observer on Wednesday 19 June 2013, to readers across Surrey and Sussex. The question and answer is below, as it appeared in the newspaper.
Read the response by Mr Sam Khemani, consultant ENT surgeon:
Dear doc, I'm having a lot of trouble sleeping and would like to find out if there's some physiological cause. I'm a 25 year old female and no more than 4lbs overweight. I snore quite heavily but my partner has never noticed me gasping for air or choking in the night, can you help? Thanks. Kristy, Horsham.
Dear Kristy, thank you for writing in with your concerns. Snoring and sleep disturbance are common problems that can sometimes represent an underlying medical condition. Snoring is thought to affect up to a third of the general population and is generally thought of as a problem that affects middle-aged men. Although more than half of all middle-aged men will be affected by snoring, it is not uncommon amongst younger men and women. In addition to obesity (which you’ve already allowed me to exclude), other common factors that are thought to contribute to snoring include body posture, alcohol and smoking.
If you don’t have these risk factors and you’re sleeping is disturbed, then you could be suffering from a problem known as Upper Airways Resistance Syndrome (UARS). UARS is caused by a reduction in the size of the airway during sleep and forms part of a spectrum of sleep-disordered breathing problems, which also include simple snoring and obstructive sleep apnoea (OSA).
Simple snorers have no issues with sleep disturbance, whilst those suffering with UARS or OSA often find themselves extremely tired during the day with reduced performance and attention. The degree of daytime tiredness can be measured using a special scoring system (the Epworth Sleepiness scale), which can help distinguish between simple snoring and UARS or OSA.
The distinction between UARS and OSA can usually only be made using an overnight sleep study or polysomnogram. This test measures periods during sleep where the oxygen levels in the blood can dip down below normal. In OSA, blood oxygen levels will dip down whereas with UARS they will not. People with significant OSA often require treatment with a form of therapy known as CPAP.
An ENT surgeon, such as myself, can identify the anatomical causes of snoring using a technique called sleep-nasal endoscopy, which is a procedure performed whilst the patient is asleep under a short anaesthetic. Once the cause is determined, a bespoke treatment can be offered which may be surgery or an alternative non-surgical treatment such as an oral splint to be worn while sleeping. When treatment is specifically tailored to the individual’s particular anatomy, excellent results in reducing snoring and improving sleep quality can be achieved.