Treatment of snoring and sleep apnoea in children is different to adults. Most children improve with tonsillectomy and adenoidectomy or weight loss.
Normal breathing is silent. Snoring or noisy breathing in sleep indicates there is partial obstruction or blockage to the passage of air through the nose, mouth and throat. When we inhale (breathe in), oxygen from the air is transferred to the small blood vessels in the lungs. When we exhale (breathe out) waste gases (carbon dioxide) leave the blood vessels in the lungs and are breathed out. Noisy breathing can cause problems with getting oxygen in and getting waste gases out of the body.
In some people, snoring is noisy but not harmful. This means the noise bothers your sleeping partner but is not causing unrefreshing sleep or health problems for you. Treatment of simple snoring is aimed at reducing the noise of snoring.
In other people, snoring is due to obstructive sleep apnoea (OSA). This means that you are not breathing well enough to have enough oxygen or to breathe out enough carbon dioxide. You may be breathing too little (hypopnoea) or stopping breathing every so often (apnoea). As the brain senses this is happening, you will rouse or wake slightly to breathe better. This interrupts the normal cycles in sleep that lead to you feeling refreshed on waking. Frequent pauses in breathing during the night causes unrefreshing sleep and daytime tiredness. This increases the risk of car accidents and can be associated with feeling down or losing concentration and losing interest in life. If OSA is untreated over several years, there is a higher risk of blood vessel disease that can lead to heart attack and stroke.
Treatment of OSA has 3 aims:
Listening to the person and their partner describe snoring and how they feel during the day helps but for accurate diagnosis a sleep study is required. A sleep study can be done at home or in hospital. Monitoring devices are attached to the nose, chest and scalp to measure the noise of snoring, the oxygen levels in the blood, what stage of sleep you are in and whether you have apnoea (pauses in breathing) while you are sleeping. In the morning the monitors are removed and the data is analysed by a sleep physician. Sleep studies done without a sleep physician are not helpful.
In adults, there are often several reasons for snoring and OSA.
Your ENT surgeon and Sleep Physician work together to find out what is causing your snoring and OSA, using:
The 3 main groups of causes are:
In most people a combination of things are required to get an improvement in snoring, starting with simple things first.
For mild sleep apnoea, treatment is the same as for snoring as outlined above, especially loss of weight, avoiding sleeping on the back and Mandibular advancement splint.
For moderate to severe sleep apnoea, the best treatment is CPAP (continuous positive airways pressure). This means wearing a mask attached to a machine to keep the air pressure high in the upper airway. This keeps the throat widely open while sleeping and allows you to breathe well. This results in a more refreshing sleep and over time will reduce your risk of heart attack and stroke.
Where can I find more information?
The Australian Sleep Health Foundation
The following information and link are from the VicRoads webpage for driving and OSA:
All motorists are required by law to advise VicRoads of any serious or chronic medical condition or disability that may impair their ability to drive safely. Sleep disorders can cause excessive sleepiness during the day. Excessive sleepiness can cause you to fall asleep unexpectedly. Sleep disorders increase your chance of crashing and put other road users at risk. Don’t drive until your condition has been investigated by a doctor and treated.
You are required by law to report any serious or chronic medical condition or disability that could affect your fitness to drive. A medical review will assess your ability to drive safely and hold a licence.
There are lots of products available online and at the pharmacy that don’t work! The consumer advocacy organisation Choice has a good review article to help you avoid them: