Snoring and sleep apnoea management, including Robotic tongue base surgery (da Vinci)

What is sleep apnea, how is it caused and how is it diagnosed?

Sleep Apnoea is a condition where the person is unable to breathe well when he or she sleeps. This results in choking episodes and the lack of oxygen reaching the brain during sleep. The patient has interrupted sleep, which in the short term may result in daytime sleepiness, fatigue and poor concentration and work performance. In the long term it can predispose them to conditions like ischemic heart disease, hypertension and stroke.

The breathing obstruction occurs from several factors. These include large tonsils, excess soft tissue around the airway, decreased muscle tone around the airway, an enlarged tongue or facial skeletal malformations.

What are the symptoms of Obstructive Sleep Apnea (OSA)?

The patient often presents with snoring at night. The snoring may change in intensity and breathing pattern may be disrupted. There may be pauses in breathing, and he or she may appear to be struggling to breathe or choke.

Obstructive sleep apnoea (OSA) often presents with increased tiredness and fatigue in the day, problems concentrating, or focus and poor work performance. The patient may also suffer from mood disturbances, anxiety, increased urination at night (nocturia).

How can we diagnose Obstructive sleep apnoea (OSA)?

Obstructive Sleep Apnoea (OSA) should be diagnosed and treated promptly. The ENT surgeon will be able to assess the airway and determine the level of obstruction. A sleep study may be done to confirm the diagnosis as well as to assess the severity of Obstructive Sleep Apoea (OSA).

What can be done to treat Obstructive sleep apnoea (OSA) and Snoring?

Weight loss is also an important aspect in the management of sleep apnoea in obese patients.

It is also important to treat and nasal symptoms from nasal allergies to improve results. If the nasal obstruction is not adequately controlled by medications, a procedure to reduce the size of the inferior turbinates and to correct a crooked nasal septum (nasal bone) may be necessary.

Surgery is aimed at specific sites of obstruction. Surgery targeted at the soft palate, pharyngeal walls and base of the tongue may be needed after further evaluation.

Patients who are not able to undergo surgery, sleeping with a positive airway pressure mask is an option.