14 June 2018
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Snoring, a form of sleep-disordered breathing, is very common. Almost half of the UK's population snore from time to time, and around a quarter of those are regular snorers. Snoring does not usually cause any problems for the person doing it but it does affect partners, family and even neighbours if it keeps them awake and can therefore be socially disruptive leading to disharmony and marital difficulties. Snoring is a noise made during breathing which results from narrowing or blockage of the upper part of your airway during sleep. This reduced airflow causes structures in your throat and palate to vibrate generating the snoring noise. If the airway blockage is severe, this may result in sleep apnoea.
The vast majority of snorers fall into the category of ‘simple snorers’. In some cases, however, snoring can be a sign of a more serious condition - sleep apnoea. This is when the blockage in your airway causes you to stop breathing for a few seconds resulting in a fall in oxygen levels in your blood causing the sufferer to wake up many times during the night. You might not even be aware that you're waking up. This causes sleep disruption, tiredness and can affect your day-to-day life. In severe cases, it can cause personality changes, intellectual deterioration, impotence and an increased risk of road traffic accidents. Because of the drop in the oxygen concentrations in the body, it can also put significant stress on the heart therefore increasing the risk of conditions such as high blood pressure and heart disease.
In order to tailor effective interventions, it is important to differentiate between ‘simple snoring’ and ‘sleep apnoea’, exclude any exacerbating factors (anatomical, thyroid disorders, medications etc) and identify the level of obstruction. The dedicated Spire Snoring Clinic, exclusively at the Spire Southampton Hospital, will enable you to seek specialist advice and treatment from Mr. Rami J. Salib FRCS (ORL-HNS) Consultant ENT Surgeon, with a specialist interest in sleep-related breathing disorders. You will undergo an initial consultation and assessment by Mr. Salib where a thorough history and examination is undertaken. It is preferable to have the bed partner present at the consultation.
General investigations including body mass index (BMI) to help define degree of obesity, Epworth Sleepiness Score – a questionnaire which assesses the risk of sleep apnoea, blood tests including full blood count and thyroid function if indicated. Sleep study – Overnight sleep study which involves monitoring of certain parameters including oxygen levels within the body to detect those suffering with significant sleep apnoea. Full ENT assessment – including an examination of the nasal airway and throat with a telescope to identify likely site of obstruction. Sleep nasendoscopy - In some cases where the site of obstruction is unclear or where it is suspected that there may be multiple sites involved, a procedure known as sleep nasendoscopy may be helpful. This is not an operation and involves an examination of the airway under a light general anaesthetic. During this procedure, done as a day case, an anaesthetist will give you an injection sufficient to induce natural sleep for 10-15 minutes and Mr Salib will examine your throat with a small flexible endoscope (camera), which he will pass through your nose. This helps assess the three-dimensional dynamic anatomy of the upper airway improving accuracy of diagnosing the site of obstruction, thus enabling a more focused management strategy.