Snoring – It may be more than just a good night’s sleep

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What needs to be understood is that snoring can be a gateway for a whole lot of health problems for the individual.

cartoon snoring person

By Dr. Saud Ahmed

Snoring has been traditionally understood as a sign of a deep and well relished sleep. The only concerning issue seemed to be the noisy disturbance caused by loud snorers, complainants mainly being the snorer’s partner or other family members.
What needs to be understood is that snoring can be a gateway for a whole lot of health problems for the individual.
In fact, many snorers suffer from an entity called obstructive sleep apnoea (OSA) wherein the upper airway collapses significantly during sleep causing reduced oxygen supply to the brain and other vital organs. The body reacts to these periods of crisis by activating catecholamines and stress hormones which significantly impact the physiology of the body.
OSA is particularly found among middle-aged, obese men, although its existence in women, children as well as in lean individuals, is increasingly recognized.
As mentioned, OSA is associated with considerable morbidity and mortality. Various studies indicate a causal relationship between OSA and hypertension, cardiovascular disease, mellitus and stroke. Obesity is the most important reversible risk factor for OSA.
Furthermore, OSA is associated with excessive daytime sleepiness which results in poor concentration at work and increased risk for road traffic accidents while driving.
Other problems include mood swings, depression, marital problems, sexual dysfunction and nocturnal enuresis.
Evaluating patients with snoring begins with a detailed clinical examination of the Nose, Throat and Larynx. In addition, the Body Mass Index and neck circumference is also documented. This is followed by a sleep study (polysomnography) which is usually done overnight to confirm and quantify the degree of OSA.
Other investigations to find out the site of airway collapse include sleep endoscopy and dynamic MRI.
Positive airway pressure devices were considered to be the gold standard of treatment. But with the 3 year compliance rates of about 40 percent, the role of the ENT surgeon in designing a multidisciplinary approach is becoming evident. Multi-level surgeries, targetting the critical areas of narrowing using technology like radiofrequency and coblation have made surgeries less invasive with quick recovery and less post operative hospital stay.
Coupled with a strict weight loss regime, these therapeutic options provide excellent benefits in alleviating the symptoms of snoring and obstructive sleep apnoea.
The Department of ENT, Head and Neck surgery at Primecare Hospital had conducted a Continuing Medical Education (CME) programme on Snoring and Sleep Apnoea on March 25th , 2018 with Dr Seemab Shaikh, a well known Senior ENT surgeon from Pune, and Founder President of Indian Association of Surgeons for Sleep Apnoea He was invited as guest faculty for the programme. About 50 doctors benefitted from the programme.
(The writer is consultant ENT Surgeon at Primecare Hospital, Bangalore)