Sleep Apnoea Treatment Singapore

Sleep apnoea is a disorder characterised by repeated interruptions in breathing during sleep when the upper airway becomes blocked. When this occurs, the tongue may be drawn against the back of the throat, blocking airflow and causing oxygen levels to drop. The brain then signals the body to wake partially to restart breathing, often with a loud gasp. These disruptions can occur multiple times per hour, leading to fragmented sleep and potential cardiovascular complications. Many individuals with sleep apnoea experience daytime fatigue, difficulty concentrating, and other health issues that affect quality of life.

Symptoms Causes Diagnosis Treatment Prevention FAQ

Symptoms of Sleep Apnoea

The symptoms of sleep apnoea may vary in severity and often develop gradually, with some individuals unaware of their condition.

Loud Snoring

While not everyone who snores has sleep apnoea, loud and persistent snoring is a common sign, often punctuated by gasps, choking sounds, or brief periods of silence.
Observed Breathing Interruptions

Bed partners frequently report witnessing pauses in breathing, followed by gasping or choking sounds when breathing resumes.
Excessive Daytime Sleepiness

Many patients experience persistent fatigue despite seemingly adequate sleep hours, often leading to difficulty staying awake during daily activities.
Morning Headaches

The reduced oxygen levels during sleep can trigger headaches that are typically present upon waking and may improve as the day progresses.
Difficulty Concentrating

Fragmented sleep leads to cognitive impairment, affecting attention span, memory, and problem-solving abilities during waking hours.
Irritability and Mood Changes

Sleep disruption can manifest as increased irritability, mood swings, or symptoms of depression due to chronic sleep deprivation.
Dry Mouth or Sore Throat

Breathing through the mouth during sleep can cause dryness or soreness in the throat upon waking.
Night Sweats

The body’s stress response to breathing difficulties may trigger sweating episodes during sleep.
Reduced Libido

Sleep apnoea can affect hormone levels and energy, potentially reducing interest in sexual activity.
Frequent Urination at Night

Sleep disruptions may increase the frequency of nighttime trips to the toilet.

Causes and Risk Factors

Several physical and lifestyle factors can contribute to the development or worsening of sleep apnoea by affecting airway structure and function.

Excess Weight

Fat deposits around the upper airway can obstruct breathing during sleep by narrowing the airway passage.
Neck Circumference

People with thicker necks may have narrower airways, increasing the likelihood of obstruction during sleep.
Age

Sleep apnoea becomes more common in older adults as muscle tone decreases, allowing tissues around the airway to collapse more readily during sleep.
Family History

Genetic factors may predispose individuals to sleep apnoea, with the condition often appearing in multiple family members.
Alcohol and Sedatives

These substances relax the muscles in the throat and can worsen obstructive sleep apnoea.
Smoking

Smokers experience inflammation and fluid retention in the upper airway, which can obstruct breathing during sleep.
Nasal Congestion

Difficulty breathing through the nose due to anatomical abnormalities or allergies can contribute to the development of sleep apnoea.
Medical Conditions

Conditions such as heart failure, high blood pressure, type 2 diabetes, and hormonal disorders may increase the risk of sleep apnoea.
Anatomical Features

A naturally narrow throat, thick neck, round head, or recessed chin can predispose individuals to sleep apnoea by creating less space for air to flow.

Diagnostic Methods

Sleep Study (Polysomnography)	This comprehensive overnight test monitors brain activity, eye movements, heart rate, blood pressure, oxygen levels, and body movements. The collected data allows specialists to determine the presence and severity of sleep apnoea by measuring how many times breathing stops or becomes shallow.
Home Sleep Apnoea Testing	For patients with suspected uncomplicated OSA, portable monitoring devices may be used at home to record breathing patterns, oxygen levels, and heart rate. These simplified tests provide convenience but may not detect certain sleep disorders or less severe cases.
Cephalometric Analysis	This specialised X-ray of the head helps assess the anatomical relationships of the skull, providing information about possible obstructions in the upper airway. The analysis can identify specific areas of narrowing that contribute to sleep apnoea.
Nasopharyngeal Examination	Using a flexible fibre-optic camera inserted through the nose, specialists can directly visualise the upper airway structure. This examination helps identify specific sites of obstruction that might contribute to sleep apnoea.
Oximetry	This simple test measures blood oxygen levels throughout the night using a small device attached to a finger. While not sufficient for a definitive diagnosis, it can help screen for potential sleep apnoea by identifying drops in oxygen levels.

Treatment Options

Sleep apnoea treatment aims to maintain an open airway during sleep, improving sleep quality and reducing health risks associated with the condition.

Non-Surgical Treatment

Continuous Positive Airway Pressure (CPAP): This treatment involves wearing a mask over the nose or mouth during sleep, connected to a machine that delivers pressurised air to prevent airway collapse. CPAP is effective when used consistently and often serves as the first-line treatment for moderate to severe sleep apnoea.
Mandibular Advancement Devices: These custom-fitted oral appliances work by positioning the lower jaw slightly forward, which helps keep the airway open during sleep. They are generally recommended for mild to moderate sleep apnoea or for patients who cannot tolerate CPAP therapy.
Lifestyle Changes: Weight loss, avoiding alcohol before bedtime, changing sleep positions, and treating nasal congestion can help manage milder cases of sleep apnoea. These adjustments may reduce the severity of symptoms and sometimes eliminate the need for other treatments.

Surgical Treatment

Uvulopalatopharyngoplasty (UPPP): This procedure involves removing excess tissue from the throat to widen the airway, including parts of the uvula, soft palate, and possibly the tonsils. UPPP is performed under general anaesthesia and may require an overnight hospital stay.
Laser-Assisted Uvulopalatoplasty (LAUP): Using a laser device, this procedure reshapes the tissue of the soft palate to improve airflow. LAUP is typically performed under light intravenous sedation in an outpatient setting and may require multiple sessions.
Radiofrequency Ablation: This technique uses a radiofrequency probe to tighten the soft palate tissue through controlled scarring. The procedure is minimally invasive, performed under light sedation, and results in less post-operative pain than other surgical options.
Orthognathic Surgery: In more complex cases, the bones of the upper and lower jaw may be repositioned to increase the size of the airway. This procedure requires general anaesthesia and typically involves a one to two-day hospital stay for recovery and monitoring.

Prevention and Management

Managing sleep apnoea requires a comprehensive approach that often combines medical treatment with lifestyle adjustments. Maintaining a healthy weight through diet and regular exercise can reduce fatty tissue around the airway. Sleeping on your side rather than your back may prevent the tongue and soft tissues from blocking the airway. Avoiding alcohol, smoking, and sedatives, particularly before bedtime, helps maintain muscle tone in the throat. For those with CPAP machines or oral appliances, consistent use enhances effectiveness. Regular follow-up appointments allow for adjustment of treatments as needed. Even with successful treatment, monitoring for recurring symptoms is advisable, as sleep apnoea can return if weight is regained or as the body ages.

Frequently Asked Questions

Can children develop sleep apnoea?

Yes, children can develop sleep apnoea, often due to enlarged tonsils or adenoids. Symptoms may include snoring, restless sleep, bedwetting, and behavioural issues rather than the daytime sleepiness typically seen in adults.

Will sleep apnoea resolve on its own?

Sleep apnoea rarely resolves without intervention. While weight loss may improve mild cases, most patients require ongoing treatment to manage the condition effectively.

Can sleep apnoea affect heart health?

Untreated sleep apnoea is associated with high blood pressure, heart rhythm abnormalities, heart attack, and stroke due to repeated drops in oxygen levels and stress on the cardiovascular system.

Dr. SL Chan

Singapore Oral Surgeon

BDS | MDS | FRACDS | FAMS |

A Leading Singapore Dental Surgeon specializing in Oral Maxillofacial Surgery, with a special interest in reconstructive & corrective jaw surgery.

Dr Chan has held major leadership position in Singapore Dentistry, including being President of the Association of Oral and Maxillofacial Surgeons (Singapore), Chairman of the Singapore Regional Committee of the Royal Australasian College of Dental Surgeons and President of the College of Dental Surgeons of the Academy of Medicine, Singapore. He has also served in the Singapore Dental Council where he chaired the Credentials Committee and the Aesthetic Facial Procedures Oversight Committee.

Bachelor of Dental Surgery (BDS), National University of Singapore (1989)
Master of Dental Surgery in Oral and Maxillofacial Surgery (Training under Professor H. Tideman), University In Hong Kong
Fellow of the Royal Australasian College of Dental Surgeons
Fellow of the Academy of Medicine, Singapore