Snoring and sleep apnoea

Snoring is due to obstruction at either one or multiple levels of your nose and throat. You may have “simple snoring” where your oxygen levels are normal or “obstructive sleep apnoea” (OSA) where you stop breathing briefly with a decrease in your oxygen levels. OSA can lead to daytime sleepiness, waking up unrefreshed, and cardiovascular events (e.g. heart attacks, high blood pressure, and strokes).

How do I know if I have OSA?

You need to have a sleep study done, which is where specialised monitoring is used to diagnose your breathing, heart rate, oxygen levels etc as you sleep overnight in a hospital bed. This is done through a referral to the respiratory sleep physicians. In certain cases a limited sleep study can be done in your own home. Associate Professor Eng Ooi will refer you for a sleep study if required.

How do I treat snoring?

Weight loss, sleeping position, dental appliances, and CPAP are usually sufficient to manage your snoring. If these fail then surgery is an option.

Nasal – septoplasty and turbinate reduction (hyperlink to nasal page)

Throat – UPPP (uvulopalatopharyngoplasty) and/or radiofrequency tongue reduction.

A/Professor Eng Ooi has been treating patients with OSA using this surgical technique for selected patients with snoring and obstructive sleep apnoea. Successful surgery means you may not need to use CPAP or snore loudly. A/Professor Ooi is part of the Multi Centre NHMRC trial performing this surgical technique to assess its overall effectiveness in patients with moderate to severe OSA. Please ask for a referral to see A/Professor Ooi if you are interested in surgery for your sleep apnoea.

What is a UPPP?

It is a procedure under general anaesthesia to remove your tonsils, part of the uvula and the redundant tissue of the soft palate. A/Professor Eng Ooi uses a specialised technique to conserve and stitch your soft palate to produce a more natural appearance. The traditional technique of cutting the uvula off and squaring off your soft palate is believed to cause more globus (sensation of a lump) and swallowing difficulties. A/Professor Ooi uses newer techniques to minimise these problems.

What is radiofrequency tongue reduction?

It is a procedure using coblation (a controlled non-heat driven process using radiofrequency energy and plasma to gently remove tissue) and a specialised wand to “shrink” the bulky tongue, therefore creating more space for you to breathe at night. There are risks with the procedure and A/Professor Eng Ooi will discuss these with you so that you can make an informed decision about your surgery.

Snoring 1 Tonsil 1

Access to the base of tongue can be difficult with standard surgical instruments. However the availability of a flexible robotic system using a single-port is an exciting development in being able to reach the tongue base and lingual tonsils. This is another exciting surgical option for patients with snoring and OSA. Associate Professor Eng Ooi is currently being proctored in the use of the Medrobotic flex system at Memorial Private Hospital to perform trans-oral robotic surgery (TORS) for patients with OSA and snoring.