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Snoring Treatment

Snoring Treatment in Singapore

Commonly Asked Question on Snoring Treatment in Singapore

Snoring happens when the tissues that line your upper respiratory tract vibrate, as a result of the airflow to your lungs being interrupted. Snoring is normal and tends to increase as you grow older. However, snoring can become a serious issue for people with Obstructive Sleep Apnea (OSA).

OSA is a condition in which breathing is disrupted multiple times throughout sleep, sometimes hundreds of times, due to obstruction in the airway. This obstruction causes the airway to narrow and eventually collapse. When your brain senses this, it jolts you awake temporarily to catch your breath and as you do so, you may snort, choke or gasp for air. This happens very briefly and you may not remember waking up. When this happens too many times night after night, it can affect your quality of sleep and the effects spill over to your daily routine.

It is estimated that 15% of the population in Singapore, suffered from OSA and this prevalence may have increased along with other health trends, such as increasing levels of obesity and sedentariness. The prevalence of OSA is also expected to rise in tandem with the ageing of our population, which is also a factor of OSA.

Common causes of Snoring issue in Singapore

OSA can be caused by a person’s physical structure or existing medical conditions. Some common causes include:

  • Genetics. People may genetically have a narrow airway. A narrow airway is also present in those with a thicker neck circumference, a large tongue, or a lower jaw shorter than the upper jaw. 
  • Obesity has often been linked to OSA. Fat deposits around your upper airway can result in a narrowed airway and hence, obstruct breathing. 
  • Endocrine conditions, such as hypothyroidism and polycystic ovary syndrome, and chronic lung diseases, such as asthma and chronic obstructive pulmonary diseases (COPD), may affect your breathing during sleep.
  • Neuromuscular conditions can result in reduced diaphragmatic strength, weakness of upper airway dilators, or cardiomyopathy, which can lead to the development of OSA.

How does Snoring affect me? 

  • Daytime fatigue due to disrupted sleep
  • A dry mouth or sore throat and/or a headache when you wake up in the morning
  • Trouble concentrating, forgetfulness, or irritability
  • Waking up multiple times in the middle of the night to pee
  • Night sweats
  • Sexual dysfunction
  • Restlessness during sleep
  • High blood pressure
  • Gastroesophageal reflux disease (GERD)

Who is at risk of Snoring in Singapore? 

In Singapore, overweight male individuals in the middle age group onwards are more likely to suffer from OSA. Cases are also more prevalent in the Chinese population – likely due to certain bone features that are more common within that ethnic group – followed by the Malays and Indians. 

Snoring Treatment in Singapore

The treatment plan will depend on the analysis of the sleep study, as well as the severity of symptoms and patient’s age, BMI, and physical features. In treating OSA, the goal is to make sure airflow is sustained during sleep. 

Continuous Positive Airway Pressure Therapy 

Continuous Positive Airway Pressure (CPAP) therapy is the first line of treatment. In this treatment, a CPAP machine is used to deliver a stable flow of oxygen into your nose and mouth to keep the airway open.

A CPAP machine generates a steady stream of pressurised air that travels through an air filter into a flexible tube. This airstream pushes against any blockages, and keeps your airway open so your lungs can receive adequate oxygen. 

There are different mask styles with different CPAP machines. The type of mask you wear would depend on your breathing habits, how comfortable the mask is, and the kind of sleep apnea disorder you have. The three types of mask styles are:

  • Nasal pillow mask has a small cushion that sits over your nostrils and sometimes prongs that fit into your nostrils. This mask is suitable for those who wear glasses or those who have lots of facial hair.
  • Nasal mask is a cushioned mask that covers your whole nose. This mask would make a better option for those who move around in their sleep.
  • Full mask is a triangular-shaped mask that covers both your mouth and nose. This mask might be recommended if you breathe through your mouth during sleep, or if you have a blockage in your nose.

Bilevel Positive Airway Pressure Therapy

Where CPAP therapy is not effective, Bilevel Positive Airway Pressure (BPAP) machines may be used. BPAP machines are non-invasive ventilators that deliver pressure in response to you inhaling and exhaling, to facilitate breathing. Home BPAP machines are about the size of a toaster, and feature a tube that connects to a mask worn over your mouth and nose.

A BPAP machine does exactly what a CPAP machine does — delivers pressurised air to keep the airway open, so that your lungs can receive oxygen. The main difference is that a BPAP machine is able to deliver air at two levels of pressure while a CPAP machine delivers air at a constant pressure.

When you inhale, BPAP machines deliver more air pressure. When you breathe out, the machine reduces the air pressure. Some BPAP machines have a timer that can be programmed to maintain a certain number of breaths per minute.

Positional Therapy

Patients may also undergo positional therapy to learn to sleep on their side, instead of on their back which can make OSA worse for some patients. Positional therapy involves wearing a device that keeps you from sleeping on your back. 

Some of these devices are worn around your waist or back, or you can make use of a backpack or tennis balls as alternatives to keep you from lying on your back. Newer devices today use gentle vibration that prompts you when you are starting to roll onto your back. Some are programmed to increase vibration when you remain on your back and the vibration only stops when you roll onto your side or stomach.

Besides keeping your off your back, these devices can also collect data about your snoring and how frequently you switch positions during your sleep. This information will be useful for your doctor.

Positional therapy may be applied on its own or combined with another treatment.

Weight Loss

As obesity is associated with OSA, obsessed patients with OSA are advised to undergo a weight loss programme to alleviate the severity of OSA. Losing weight could also improve quality of life and reduce daytime fatigue.

Surgery

In cases where none of these methods work, you may consider surgery. Surgery may be most effective for patients whose OSA can be surgically corrected as in the case of an obstructing lesion in the airway. While surgical treatment can be effective, it does not completely eliminate OSA.

Allergy & Sinus ENT Specialist Centre
Head & Neck Surgery Singapore

Dr Soma Subramaniam
MBBCH (IRE), DOHNS(ENG), MMED-ORL(NUS), FRCS-ORL(ENG)
Consultant ENT Specialist and Surgeon
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