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Sleep apnoea got your heart in your throat? Perhaps it’s time to ditch the CPAP and fetch the scalpel

The link between obstructive sleep apnoea (OSA) and cardiovascular disease (CVD) is clear. Its well-established association with essential hypertension is thought to link OSA to an increased risk of atherosclerotic and hypertensive sequelae. However, data on the long-term impact of...

Medical trends in sleep disordered breathing

This duo provide an eloquent outline of sleep disordered breathing in general, with particular emphasis on the medical impact and associations of the condition. The increasing prevalence of the condition is described, with increasing worldwide obesity, increased association of cardiac...

How useful is AHI?

There is a growing unease in the sleep medicine world about the usefulness of the apnoea-hypopnoea index (AHI). Most of our objective evidence about obstructive sleep apnoea (OSA) is in some way related to the AHI, and the respiratory physicians...

Should human beings sleep in the prone position?

Are we poised for a ‘sleep prone’ campaign to reduce nocturnal apnoeas? Prof Armin Moniri presents a fascinating account of how sleeping position can affect obstructive sleep apnoea. Inspired by sleeping position of other mammals, a new mattress and pillow...

Patient factors associated with spontaneous CSF leak

This article highlights the role of obesity, sleep apnoea and raised intracranial pressure as linked pathologies in the aetiology of the spontaneous cerebrospinal fluid (sCSF) leak. The authors link sCSF leak with obesity and comment on sCSF leak incidence increasing...

Hypoglossal stimulation for OSA

Continuous positive airway pressure (CPAP) is a highly effective treatment for moderate-to-severe obstructive sleep apnoea (OSA), but suffers significantly from poor patient adherence. This paper reports the three-year outcomes of a prospective multicentre cohort study examining the effect of hypoglossal...

Can obstructive snoring affect the snorer’s ears as well?

Patients with obstructive sleep apnoea (OSA) often show severe nasal obstruction, chronic sinusitis and/or a deficit of nasal mucociliary clearance with nasopharyngeal stagnation of secretions possibly predisposing to eustachian tube dysfunction (ETD). This clinical prospective study investigates ETD, nasal resistance...

Postoperative complications in OSA patients

This well researched meta-analysis describes the various complications obstructive sleep apnoea (OSA) patients may acquire after surgery. These American reviewers found that OSA patients after non-upper airway operations, were more like to suffer (compared to non-OSA patients), from the following...

Can surgery make you a better driver?

Obstructive sleep apnoea is a condition that can have far reaching health, economic and safety implications for the individual inflicted with the condition, as well as those in their immediate and wider surroundings. Having the freedom to drive taken away...

The role of the respiratory physician in sleep medicine

ENT surgeons may feel that they are the first point of referral for the majority of patients with snoring and possible obstructive sleep apnoea, but in reality a significant number of patients with sleep-disordered breathing (of any cause) are seen...

Which surgical procedure is more effective in treating OSA? Tonsillectomy or modified uvulopalatopharyngoplasty?

Obstructive sleep apnoea (OSA) is a recognised condition that is increasing in prevalence, affecting the quality of life in certain individuals. Although the first line management is non-surgical, this paper highlights the two different surgical procedures offered to patients. The...

Surgical management of sleep disordered breathing

Snoring and sleep-disordered breathing are often described as multi-level problems, and different surgical procedures are required to treat the various sites of airway narrowing and/or collapse. Jonathan Hobson gives us an eloquent run-through the various options available to the ENT...