Sleeping well is an essential part of staying healthy, but many people often underestimate the dangers of poor quality sleep in both adults and children.
THE MOST IMPORTANT SLEEP CONDITION TO GO UNDIAGNOSED AND UNTREATED IS OBSTRUCTIVE SLEEP APNEA (OSA), WHERE RECURRENT AIRWAY COLLAPSE LEADS TO FREQUENT DIPS IN OXYGEN LEVELS.
In adults, this chronic lack of oxygen supply to vital body organs such as the brain and heart may lead to heart failure, strokes, sudden death and even reduced life expectancy, if left untreated over time.
WHEN SNORING IS A PROBLEM IN CHILDREN
In children, snoring seems quite innocuous, but approximately 10% of children who snore may suffer from underlying paediatric OSA. In most cases, this is almost always due to enlarged tonsils and adenoids. The tonsils and adenoids form part of a specialized ring of lymph gland tissue behind the nose and throat and may be quite prominent in young children, and even teenagers and young adults. Enlarged tonsil and adenoid tissue may obstruct the airway when the child is asleep, affecting his breathing and resulting in poor sleep quality due to a chronic lack of oxygen. This may affect cognitive and behavioural development, possibly impairing academic performance. Children with OSA may feel tired and lethargic during the day and may present with subtle signs such as recurrent bedwetting at night.
TREATING SNORING PROBLEMS IN CHILDREN
If your child persistently snores or seems to require extra effort to breathe when asleep, this should be evaluated. Some studies also suggest that in children with enlarged adenoids, chronic mouth breathing over a prolonged period may result in permanently elongated facial shape and structured, which is classically described as “adenoidal face”, If simple measures such as anti-allergy sprays do not help, then surgical removal of the enlarged tonsils and adenoids may be indicated to clear airway blockage. Although it is natural for parents to be concerned about the option of surgery in their children, the procedure is generally straight- forward and usually cures the problem in approximately 90% of children.
TREATING SNORING PROBLEMS IN ADULTS
Adults who snore incessantly should have a thorough nose and throat assessment and undergo a sleep study to ascertain the severity of any underlying OSA. Treatment using Continuous Positive Airway Pressure (CPAP) and/ or surgery may be advisable. CPAP is a special device which drives pressurised air into the patient’s nose and throat to keep his airways open while asleep. The most suitable candidates for surgery tend to be those who are not obese, and whose sleep study has not demonstrated severe OSA. My patients are usually offered a trial of CPAP to see if they tolerate it. Studies have shown that for CPAP to be effective, patients need to keep the CPAP on for a minimum of four hours each night. However, some patients may find it uncomfortable. If so, we will explore the surgical option after detailed counselling with patients and their families.
ALL’S WELL WHEN YOU SLEEP WELL
You should take note that if your spouse snores incessantly, it may be detrimental not only to his own health but could affect your well being too if it causes you to suffer constant sleep disruption. Recent studies show that repeated nights of poor quality sleep have negative effects on one’s blood sugar level, immune system, and mental health, as well as a possible increased risk of dementia. So, treating your spouse’s sleep disorder can potentially benefit both of you, health-wise.
Dr Annabelle Leong is an Otolaryngologist with fifteen years of ENT experience, having trained and worked in the United Kingdom, Canada and Singapore. She received her MBBS with Distinction from Guy’s, King’s and St Thomas’ Hospitals in London, UK, winning the Roger Warwick Prize in ENT and Negas Cawthorne Essay Prize in ENT as an undergraduate. She has managed a wide range of both paediatric and adult ENT conditions throughout her postgraduate specialist training in London at Great Ormond Street Hospital for Children, the Evelina Children’s Hospital, the Hearing Implant Centre at Guy’s and St Thomas’ Hospitals, Charing Cross Hospital, King’s college hospital and the National Hospital for Neurology/Neurosurgery, Queen’s Square.
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