At Home Christian Jessen 2014 - 115

| 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
Mr Bhik Kotecha
MBBCh, FRCS (Eng),
FRCS (Ed), FRCS (Orl),
DLO (pictured, left)
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.

About 10% of these patients have a
condition known as obstructive sleep apnoea,
whereby 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 children and adults. The most common
cause in young people is enlarged tonsils and
adenoids. Evidence shows that removal of the
tonsils and adenoids dramatically improves their
quality of sleep as well as their 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

'SNORING OCCURS
AS A RESULT OF
TURBULENT AIRFLOW
AND CAN AFFECT
CHILDREN AND
ADULTS. THE MOST
COMMON CAUSE IS
ENLARGED TONSILS'

back of the tongue. Recent developments in
the surgical ﬁeld include the use of laser,
radiofrequency equipment and 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 may
also encourage CPAP in many sleep apnoea
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 that it
vibrates less, often uses laser or radiofrequency.

being overweight could aggravate the symptoms.
Evaluation of these patients would try to identify
the obstruction. In addition, 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 patients 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.

FOR MORE INFORMATION
Call Mr Kotecha at his private ofﬁce
on 01277 695653, or visit
www.snoringmanagement.co.uk

Fix the problem

Surgery in adults could deal with the problems
arising from the nose, soft palate or indeed the

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 Christian Jessen 2014

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