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17 APRIL 2023 Breathe well, sleep well, look well Professor Alwyn D’Souza discusses the importance of nasal breathing


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EXAMINATION OF THE NOSE AND THROAT


A blocked nose is a common condi- tion that aff ects 10-40% of the popu- lation. It’s commonly caused by either swelling of the nasal lining in reaction to pollutants and allergens, or structural deformities such as a bent nose, deviated nasal septum or nasal polyps. T e nasal cavity helps humidify,


warm and fi lter the air we breathe, before this air passes to the lungs. T is means that nasal issues not only can aff ect the lungs, but also cause snoring and obstructive sleep apnoea (OSA), which is the cessation of breathing during sleep, for more than 10 seconds at least fi ve times an hour. OSA leads to respiratory distress, causing brain activation during sleep. T is


triggers micro


awakenings, preventing patients from achieving complete restorative sleep. T is cycle has several eff ects: 1. Social eff ects — a negative impact on personal relationships. 2. Neurocognitive


symptoms,


such as daytime sleepiness, drowsiness, defi cits in attention, concentration, memory, and exec- utive functioning.


3. Health risks — the body responds to OSA by releasing stress hormones, and toxins, which could lead to high blood pressure, obesity and diabetes. At its worst, OSA could potentially contribute to heart attacks and increase the risk of road traffi c accidents, both of which could be avoided with early diagnosis and appro- priate management.


T e most easily identifi ed symptom of OSA is snoring, which accounts roughly 30 million people in the UK, including 41.5% of the adult popula- tion, but it also occurs in children. Both men and women are aff ected in a 2.3:1 ratio. Men tend to snore louder than women, and though 58% of snorers are between ages 50-59, all age groups are aff ected. However, snoring is just a


symptom, but a complex one, as the sound generates persistent vibra- tion around the nasal and throat


BLOCKED NOSE, SNORING AND OSA: EFFECTS ON THE INDIVIDUAL


expert nasal surgeon in an appro- priate clinic setting. An endoscopic examination is an


T ough snoring and OSA can’t be stopped at will, nor 100% cured, both can be successfully reduced. T e fi rst step in treating snoring is to diagnose the source of the noise


structures including the tonsils, palate,


base of the tongue and


surroundings. T e vibration progres- sively damages the throat nerves and muscles contributing to the collapse of the airway that causes OSA. T ough snoring and OSA can’t be stopped at will, nor 100% cured, both can be successfully reduced. T e fi rst step in treating snoring is to diag- nose the exact source of the noise, which includes a full examination and assessment of the nasal passages and upper airway structures, which should ideally be performed by an


Patient care doesn’t stop at surgery, as endocrine complementary studies, weight control and exercise should also be explored


THE WHITE AREA SHOWS THE AIRWAY BEFORE AND AFTER SEPTO-RHINOPLASTY SURGERY CARRIED OUT TO IMPROVE AIRWAY AND AESTHETICS


novel surgical procedures such as radiofrequency, ablation tonsillec- tomy and suture suspension of the pharyngeal muscles. Other non-in- vasive procedures such as mandib- ular advance splints or the novel neuromuscular electrical stimula- tion of the tongue may be required to endure the tone of the muscles in the tongue and mouth. Patient care doesn’t stop at surgery though, as endocrine complementary studies, weight control and exercise should also be explored to achieve a comprehensive care programme to impact snores and the OSA patient’s wellbeing. Achieving adequate nasal breathing allows better sleep quality


while reducing the snoring signif- icantly, so patients go about their day-to-day life feeling refreshed and looking forward to going to sleep. At this snoring clinic, based at 55


Harley Street, this comprehensive streamlined approach has become its ethos. T e services headed by Professor Alwyn D’Souza, and his


team of


essential as it means doctors can assess whether the airway can guar- antee a permanent and fl uid passage of air without collapsing the upper airway at night. Once the cause of the snoring has


been identifi ed, the nasal compro- mise is generally addressed fi rst, perhaps under surgical correction as part of septo-rhinoplasty proce- dure. Other sources of obstruction (such as the bulkiness of the palate, tongue base and large tonsils) can then be addressed by a variety of


NASAL ENDOSCOPY


specialised talented


surgeons, professionals and other allied specialists, work together to help patients breathe and sleep better and to improve their wellbeing.


For further information visit:


londonfacialsurgery.org londonentassociates.org


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