Looking after your Ears, Nose and Throat

IMPORTANT: Children are not meant to snore.

Note: all our clinics are able to offer in office procedure of upper airway assessment with a flexible nasopharyngolaryngoscope (fancy name for an ENT torch) to determine the level of obstruction and offer advice on surgery, jaw splints and CPAP.

Snoring is the noise made by people when their airway becomes blocked or obstructed whilst they are asleep. This may affect children and adults alike. The most important issue in adults that snore is whether they have a condition known as Obstructive Sleep Apnoea (OSA). This condition describes the situation where the blockage is so bad that airflow stops and the person stops breathing. This places a stress on the body that has long term effects on the heart, brain, and many other body systems. Given that we spend about one third of our lives asleep, the problems we experience during this time overflow into our normal day to day functioning. The following briefly outlines the condition in children and adults.

The snoring child
The child who snores presents a challenge to the specialist in terms of diagnosis and treatment. In cases where the child experiences periods where they stop breathing (apnoea) then the treatment of choice is usually to recommend removal of their tonsils and adenoids (glandular tissue that lies at the back of the mouth and nose, respectively). The reason for this is that there are well documented detrimental effects of OSA on their heart, growth and mental development if left untreated.

For snoring children where apnoea does not occur, then the impact on their function during the day is most important. If the child who snores on a regular basis experiences difficulties with concentration, behavioural problems (for example Attention Deficit Disorder), bed-wetting, sleepiness during the day, feeling tired in the morning or is doing poorly at school, they may have a lesser form of obstructed breathing at night known as Sleep Disordered Breathing (SDB). There is a growing body of scientific evidence that children with sleep disordered breathing should also be treated. This is also usually by removing the tonsils and adenoids. For more information about this topic, you may wish to review the information available at www.ent4kids.com.au.

The snoring adult
Snoring in adults is usually noticed by their bed partner first. Occasionally it is so bad that it leads to them no longer having a bed partner! Whilst snoring in the household may be a source of amusement, it can be bad enough that marriages and relationships break down.

It is important to differentiate simple snoring, where there is loud noisy breathing, from obstructive sleep apnoea (OSA), where there is a blockage to the breathing. OSA can be quite scary for bed partners to witness and they often report having to wake their significant other up so they will breathe again.

The health impact of OSA, compared to simple snoring, is quite substantial. They include an increased risk of heart disease, increased risk of stroke, the development of high blood pressure which may require medication, day time fatigue- including whilst driving a car (driving whilst sleep deprived is no different to drunk driving), and mood disorders. It is currently estimated that at least 20% of the adult population suffers from OSA so it remains a hidden disease in need of urgent attention.

The best means of making the diagnosis is performing a special test known as a sleep study. There are many different types of these, with different capabilities of diagnosing sleep apnoea. There are now test kits which can be taken home by patients. An alternative to testing at home, or where the test at home is inconclusive, involves a sleep test being performed in hospital during an overnight stay.

The treatment of snoring is different from the treatment of sleep apnoea. ENT Surgeons are becoming increasingly involved with the management of sleep apnoea in order to offer a greater range of treatment options to sufferers. More information is available at www.sleepstudy.com.au.

If you would like to make an appointment with us to discuss snoring in either yourself or a family member, we would be happy to do so. A referral from your GP will be required.