Sinchew Daily – 17th November 2022
“Some people assume that snoring is a sign of deep sleep. This is a misconception, in fact, it could be a sign of serious health problems leading to sudden death while sleeping.
Why do you snore?
“Snoring is caused by partial blockage of the upper airway (nose and throat). Among them, 86% of the blocked part involves palatal collapse. Therefore, doctors will evaluate the condition of the palate and the size of the tonsils to determine the exact cause”.
“Patients with sinusitis are blocked by secretions and airway become narrow. Breathing then vibrate the mucosal edge of the nasal passages or secretions, resulting in bursts of snoring”.
“And there are cases of nasal allergies that cause nasal mucosal swelling, and they will involuntarily breathe through their mouths while sleeping.
Snoring due to throat muscle weakness can be life-threatening
Snoring can lead to forgetfulness, fatigue, lack of concentration, and lack of energy in adults. It can even induce high blood pressure, heart disease, arrhythmia, myocardial infarction, and stroke. In severe cases, the upper airway can be completely blocked and airflow is affected leading to suffocation.
For the elderly, snoring is mostly due to the decrease of soft tissue muscle strength and muscle relaxation in the throat, which leads to Obstructive Sleep Apnea (OSA).
Dr. Raymond also added that in cases of obesity, most obese people have snoring and possibly diabetes problems. Naturally, sleep quality decreases resulting in fatigue. In order to compensate, they will increase intake of sugar, which leads to exacerbating diabetes – it’s a vicious cycle”.
Children’s habitual mouth breathing
“Most children today have snoring problems, especially obese children. When obese children breathe through their mouths for a long time, it could lead to some form of deformity (adenoid face). Snoring could also affect a child’s intellectual development, plus, it is closely linked to Attention Deficit Hyperactivity Disorder (ADHD). Therefore, when a child has chronic nasal congestion and snoring, parents should see a doctor immediately”.
When patients suffer from obstructive sleep apnea, doctors will ask the ‘STOP’ questions:
S (Snore): Do you snore loudly?
T (Tired): Do you often feel tired or sleepy during the day?
O (Observed): Has anyone observed you stop breathing while you were sleeping?
P (Pressure): Do you suffer from high blood pressure or are you receiving treatment for high blood pressure?
If you ticked two or more symptoms means you have a high probability of suffering from obstructive sleep apnea.
Clinically, Apnea-Hypopnea Index (AHI) or Respiratory Disturbance Index (RDI) is often used to evaluate the severity of OSA, and it is categorized as:
5 to 14 times: mild symptom
15 to 30: moderate symptom
30 times or more: severe symptom
The doctor will also assess the oxygen saturation of the patient, with 85% to 95% being mild, 75% to 85% being moderate, and less than 75% being severe.
If the patient requires surgery, the otolaryngologist will use nasal endoscopy to assess the position of the obstruction in the airway and then draw up a surgical plan to improve postoperative sleep conditions and increase the success rate of the surgery.
The 5 questions about snoring: Is it more difficult to breathe when you lie on your stomach and press your lungs?
Question 1: Can the sleeping position improve snoring?
Answer: “Changing the sleeping position can improve snoring. It is recommended to adopt a side sleeping position to reduce upper airway obstruction. Dr. Raymond also doesn’t think that sleeping on the stomach would help, because it is difficult to breathe during sleep especially when the lungs are pressed for a long time”.
Question 2: Can I drink alcohol or take sleeping pills for a sounder sleep and stop snoring?
A: “Alcohol and sleeping pills are not recommended for patients with OSA. Alcohol and sleeping pills can relax the throat muscles of the patient, which in fact increase the risk of snoring”.
Question 3: Can anti-snoring devices, nasal dilators, and headgear on the market effectively improve snoring?
Answer: “The anti-snoring devices sold in pharmacies are not very effective. Currently, Continuous Positive Airway Pressure (CPAP) is the gold standard treatment for sleep apnea. It can effectively inject air into the patient’s chest continuously. CPAP can hold open the airway, and prevent muscle collapse that blocks the airway”.
Q4: Which surgeries can treat snoring?
A: “The surgical method depends on the cause of the snoring, and some of these surgeries include:
- Anti-snoring stent implantation (Pillar Implant). This surgery is suitable for patients with mild OSA, but its overall effect is limited”.
- Adenoid and tonsillectomy (adenotonsillectomy) are also surgical methods to improve snoring. People used to do this operation because of inflammation of the tonsils, but now this operation is used to prevent OSA. It is the mainstay of treatment for children with OSA, with a cure rate of 85%.
- Radiofrequency ablation (radiofrequency ablation somnoplasty), which uses electrode needles to release radio frequency to tighten (harden) the excess soft palate tissue – the result is 80% of OSA patients experienced improvement in snoring.
- Uvulopalatopharyngoplasty (UPPP) removes excess tissue in the back of the throat (tonsils, overhang and one-third of the soft palate).
- The palatal lift operation, it is a modified cautery-assisted palatal stiffening operation that shortens the uvula and removes the soft palate mucosa (horizontal strip) above the uvula, thereby “elevating” the palate”.
Question 5: Can weight loss improve snoring?
Answer: Yes, but a weight loss of 1 or 2 kg will not have the desired effect. Obese people need to lose an average of 12 kg to significantly improve their snoring condition.