At Home with Dr Christian Jessen - 92
| PROMOTION|
Put an end to
unsettled sleep...
Snoring is an extremely common problem, affecting up to 40% of the population,
and it can disrupt the sleep quality of both the patient and their partner
M
r Bhik Kotecha MBBCh,
FRCS (Eng), FRCS
(Ed), FRCS (Orl), DLO
(pictured above) is
a consultant Ear, Nose and Throat
(ENT) Surgeon at Royal National
Throat, Nose and Ear Hospital,
London, and at Queen's Hospital,
Romford, Essex. He works with most
adult and paediatric ear, nose and
throat problems, and sleep disorders.
Around 10% of patients who snore have
a condition known as obstructive sleep apnoea,
where they have breath-holding episodes in
their sleep which can cause oxygen deprivation.
This can result in poor sleep, morning
headaches and daytime sleepiness. If sleep
apnoea is left untreated, the chances of a
patient developing other disorders such as
ischaemic heart (or coronary artery) disease,
stroke and diabetes can increase.
The secrets of snoring
Snoring occurs as a result of turbulent airflow
and can affect both children and adults. The most
common cause in young people is enlarged
tonsils and adenoids. Evidence shows removal
of the tonsils and adenoids dramatically improves
their quality of sleep as well as cognitive function.
In adults, the problem could be due to an
obstruction in the nose as a result of a deviated
nasal septum or nasal polyps, but much more
commonly it is the redundant, floppy soft palate
in the throat that is the culprit. Certain lifestyle
factors such as smoking, an increased alcohol
intake or being overweight could aggravate the
symptoms. Evaluation of these patients would aim
to identify the cause of the obstruction.
Some patients may require a sleep study to
ascertain whether they are 'simple snorers' or
have 'obstructive sleep apnoea'. Patients with
moderate or severe variations of this would benefit
from a Continuous Positive Airway Pressure (CPAP)
machine. This air pressure device is very effective
but some find it cumbersome and many seek an
alternative. Another non-surgical solution is to
use a Mandibular Advancement Device (MAD) to
hold the jaw and tongue forward when sleeping.
Generally, people across the world who use
these devices do not stick to them; having to
use them every night can be tedious. Surgery
for selected patients could offer an alternative.
Fix the problem
Surgery in adults deals with problems arising
from the nose, soft palate or the back of the
tongue. Recent developments in the surgical
field include the use of laser, radiofrequency
equipment and also transoral robotic surgery
for the more complex cases.
Nasal surgery, in the form of septoplasty, nasal
polypectomy or endoscopic sinus surgery may not
only help patients with 'simple snoring' but could
also encourage CPAP in many sleep apnoea
'SNORING OCCURS AS A RESULT OF TURBULENT
AIRFLOW AND CAN AFFECT CHILDREN AND
ADULTS. THE MOST COMMON CAUSE IN
YOUNG PEOPLE IS ENLARGED TONSILS'
patients if they are finding it difficult to tolerate this
form of therapy. Surgery, when performed on
the soft palate to shorten and stiffen it so it vibrates
less, often uses laser or radiofrequency techniques.
FOR MORE INFORMATION
Call Mr Kotecha at his private office
on 01277 695653 or
visit www.snoringmanagement.co.uk
Mr Kotecha also offers services at:
Nuffield Hospital, Shenfield Road,
Brentwood, Essex CM15 8EH
Call 01277 695695 (Mon, Thur, Sat)
Spire Hartswood Hospital, Eagle Way,
Warley, Brentwood, Essex CM13 3LE
Call 01277 232525 (Thur, Sat)
Spire Roding Hospital,
Roding Lane South, Ilford, Essex IG4 5PZ
Call 020 8551 1100 (alternate Mondays)
Royal National Throat, Nose & Ear Hospital,
330 Grays Inn Road, London, WC1X 8DA
Call 020 3456 5219 (Wed afternoons)
http://www.snoringmanagement.co.uk
At Home with Dr Christian Jessen
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