Snoring (Stertor) is extremely common yet complex and involves children and adults, males and females and varies significantly in intensity and degree. There are also numerous causes and effects that it has on the human body and treatment options. The physical and emotional sequelae extend beyond the patient to affect the spouse and potentially their marriage. We all snore at times but the severe snorer and the one who even stops breathing (apnoea), needs to be urgently identified and treated.
Causes
Why do some people snore and others don’t and therefore what are the main causes?
There are multifactorial combinations of causes but they can be divided into two main categories, one being physical and the other being lifestyle. The typical physical profile of a severe snorer is someone who is overweight and probably shorter than average, with a short, thick neck. One is less likely to snore therefore if tall and thin. Snoring can be caused by and aggravated by other anatomical factors from the nose, chin, mouth and down the airway to above the larynx. e.g. Nasal polyps, large adenoids, receding chin and even tumours. It is therefore essential that every patient is examined thoroughly prior to definitive diagnosis and management.
An Ear, Nose and Throat Specialist is the best qualified to assess these patients, who will also need flexible nasopharyngolaryngoscopy which can be done in the consulting rooms or under a light general anaesthetic. In the absence of other pathologies, the patient with the high BMI (Body Mass Index) will have soft floppy obstructive tissue predominantly in the nasopharynx and the back of the palate going down to the oropharynx.
Apnoea
Severe snoring can result in the person stopping breathing completely, this is called apnoea. This can be diagnosed on history by the spouse or even a recording and obviously by a sleep study. This sleep study is very important in confirming and assessing severity and can be done at home. Various indices are measured including oxygen levels. This sleep study in analysed and management recommendations are put forward.
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