10 MARCH 2019 • HEALTHCARE INNOVATIONS


Specialist clinics


31


A novel non-surgical treatment for snoring


Snoring is an extremely common problem affecting both males and females, and up to 40% of the population. It can disrupt the quality of sleep of both the patient and their partner


About 10% of these patients may have a condition known as obstruc- tive sleep apnoea, whereby they have breath holding episodes in their sleep which can cause oxygen deprivation. Tis can result in poor sleep, morning headaches and daytime sleepiness. If sleep apnoea is left untreated then the chances of developing other disorders — such as ischaemic heart disease, diabetes, memory problems and stroke — can increase. In addition to having higher risks of developing the above problems, intrusive snoring can play a detrimental role in relation- ships and many of these patients are experiencing marital disharmony. Snoring occurs as a result of a


turbulent airflow and can affect both children and adults. Te commonest cause in children is due to enlarged tonsils and adenoids, and there’s plethora of evidence in the medical literature to demonstrate that the removal of tonsils and adenoids in these children dramatically improves their quality of sleep as well as their cognitive function. In adults, the problem could be


due to an obstruction in the nose as a result of a deviated nasal septum or nasal polyps, but more commonly it’s the redundant, floppy soft palate in the throat that may be the culprit. One of the anatomical regions that’s often not given much attention or over- looked is the base of the tongue. Often there may be one or more anatomical region contributing to the snoring. Evaluation of these patients would include full assessment of the nose and throat with an endoscope and a sleep study (which can be performed in the patient’s home).


CONSIDER NON-SURGICAL OPTIONS Surgical intervention is recently gaining popularity but surgery is not without problems and may not necessarily help all sufferers. Tere- fore, before embarking on surgical intervention, it’s wise to consider


all conservative and non-surgical options available. Certain lifestyle factors, such as


increased alcohol intake or obesity, could


aggravate snoring and


addressing these could be helpful. Sleeping on the back could also worsen snoring as the tongue under these circumstances would drop backwards and occlude the airway and exacerbate the turbulence of airflow. Tus avoiding sleeping on one’s back may reduce snoring. In patients who experience diffi-


culty in breathing through their nose, the use of nasal strips (Breatherite) or clips (Nozovent) may improve the airflow and thus reduce snoring. Te former is applied externally, whereas the clip is inserted internally just at edge of the nostril. In conjunction with this, or as an alternative in patients with rhinitis, intranasal steroid spray may be useful. Patients with under- lying allergies may also benefit from having antihistamines. In patients with moderate or severe sleep apnoea, the treatment of choice is CPAP. Oral appliances such as mandib- ular advancement devices are often used for simple snoring or mild sleep apnoea (figures one and two). Tese are particularly useful in bringing the tongue forward during sleep and improving the airway. However, many would find this cumbersome and diffi- cult to tolerate during sleep.


FIGURE 3: SNOOZEAL DEVICE


SNOOZEAL A recent novel innovation of a device called SnooZeal may overcome this problem (figures


three and four).


SnooZeal provides a daytime solution to a night-time problem. Unlike tradi- tional therapies, SnooZeal is the first treatment to focus on the root cause of snoring, using gentle daytime stim- ulations to improve the tone of tongue muscles and reduce night-time obstruction and snoring. Patients have full control of the device through a smartphone app, monitoring snoring and progress over time. By using the device for just 20-30 minutes a day, participants in clinical trials in the UK and Germany produced


consistently great improvements. Patient testimony reveals the treat- ment to be ‘non-invasive’ yet ‘trans- formational’, providing ‘swift’ results and leading to patients and partners sleeping better. Trials demonstrated that up to 90% of individuals using the product showed some improvement, while 75% demonstrated significant reduction in their snoring. Tis novel device appears to be useful for some simple snorers and mild sleep apnoea patients, but could have a potential adjunctive role in improving CPAP


For more information get in touch: Professor Bhik Kotecha MBBCh., M.Phil., FRCS consultant ENT surgeon at snoringmanagement. co.uk


compliance by toning the muscles of the tongue and thus reducing pressure requirement.


FIGURE 4: SNOOZEAL DEVICE


FIGURE 1: MANDIBULAR ADVANCEMENT DEVICE


FIGURE 2: PATIENT WEARING A MANDIBULAR ADVANCEMENT DEVICE


27 Harley Street, London — 01277 695653 Nuffield Hospital Brentwood, Essex — 01277 695695 Spire Hartswood Hospital, Brentwood, Essex — 01277 232525


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56