CPAP
Continuous Positive Airways Pressure (CPAP) is provided via a special device with a mask which fits over the nose or nose and mouth during sleep. A controlled flow of air from the device helps to keep the airways open and unobstructed during sleep, so relieving snoring and sleep apnoea. This can make a huge difference to those with significant OSAS as they wake after a good night’s sleep feeling refreshed often for the first time in years.
Consultation
You will be examined and asked in depth about your snoring and sleep difficulties, and the affect this has on you, your partner and family. A nasal and sinus endoscopy or fibreoptic examination of your larynx and pharynx may take place. A plan will be made for further investigation, including sleep testing.
CPAP
Continuous Positive Airways Pressure (CPAP) is provided via a special device with a mask which fits over the nose or nose and mouth during sleep. A controlled flow of air from the device helps to keep the airways open and unobstructed during sleep, so relieving snoring and sleep apnoea.
Device Therapies
Some patients will benefit from the use of a device therapy. This is usually a specially fitted device worn in bed. There are two types of device, which work via different modes to improve the sleep experience of the patient.
Insomnia and Management of Sleep Health
Treatment from a clinical psychologist with cognitive behavioural therapy may provide improved management of sleep and insomnia disorders. In some cases relationship advice may be of benefit.
Jaw Surgery
Jaw surgery to bring the lower jaw (with the tongue and throat muscles) forward is very rarely undertaken, but may be advised in exceptional cases.
Lifestyle and Sleep Hygiene
A holistic review is undertaken, with professional advice being given on items such as diet and nutrition, exercise and alcohol intake. Specialist therapists such as dieticians, physiotherapists and personal trainers may be advocated.
MAS
These can be moulded in hot water or specially fitted by an orthodontist with a full dental assessment. The Mandibular Advancement Splint (MAS) is worn like a gum shield over top and bottom teeth. It works by pulling the lower jaw forward. The tongue moves forward too, creating more space in the throat. The splint also stiffens the upper throat muscles so that they are less likely to vibrate.
Nasal Surgery
Some patients who snore have a blocked nose. Surgery to the nasal passages is undertaken in order to improve the flow of air and relieve snoring.
Lifestyle Therapies
In some instances, changes to a patient's lifestyle will help in the treatment of snoring and sleep apnoea. Lifestyle therapies may constitute a stand-alone treatment or indeed, support surgery or device therapy.
Orthodontist Splint
An orthodontist splint is a more sophisticated MAS, especially fitted by a Consultant Orthodontist, who will assess your jaw and teeth before making a customised splint.
Obstructive Sleep Apnoea Syndrome (OSAS)
Throat narrowing is extreme and the throat may collapse during sleep. Normal breathing is unable to overcome this blockage leading the airflow to drop (hypopnoea) or stop (apnoea). The brain is alerted, the sufferer stirs, resuming normal stiffness in the throat. Air is able to flow in again and breathing recommences.
Sleep Testing
Sleep testing provides detailed analysis of the underlying causes of snoring and sleep disorders. You will be required to be fitted with a specialist device such as an Apnoeagram or a WatchPat, worn during sleep. This establishes whether your snoring also incorporates sleep apnoea and helps identify the physical causes of your snoring. Final treatment planning can now usually be made.
Snoring
Obstruction of the normal air flow during breathing causing vibration of the throat muscles.
Loud disruptive snoring may need assessment in order to ensure continuing sleep health and prevent worsening of the condition and further health disorders developing.
Surgery
Normally considered after other avenues have been fully investigated, surgery may be recommended for certain people in order to treat the causes of their snoring and sleep disorder. The diagnosis will indicate whether you are a suitable candidate for either surgery to the throat or nose, or very rarely the jaw, depending upon which tissues are causing the snoring obstruction.
Throat Surgery
One of three surgical procedures to the throat will be undertaken if excess throat tissue or obstruction is identified as being one of the causes of your snoring and sleep apnoea.
Treatments
Various treatments are available
Upper Airway Resistance Syndrome (UARS)
This disorder is characterised by increased airway resistance in the throat to breathing during sleep. During sleep, the muscles of the throat relax causing a significant narrowing of the throat. With UARS, snorers can overcome their airflow problems and maintain normal airflow by breathing much harder.
