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Obstructive Sleep Apnoea

Research has revealed that 1 in 3 Singaporeans struggle with Obstructive Sleep Apnoea (OSA). It occurs when breathing frequently stops and starts during slumber.

Do you have Obstructive Sleep Apnoea?

Consider seeking medical help if you experience the following signs and symptoms.

  • Deep snoring
  • Breathlessness during sleep
  • Waking up with a dry mouth
  • Morning headache
  • Insomnia
  • Hypersomnia
  • Grumpiness
  • Trouble paying attention
  • Bruxism
  • Dental problems such as cavities and gum recession

What causes OSA?

OSA happens when muscles in the back of the throat relax, causing the upper airway to narrow and become blocked. Since the diaphragm and chest muscles must now work harder to reopen the airway and resume breathing, choking, snorting or gasping may result – as often as hundreds of times in some people – throughout the night. This disrupts oxygen flow, reduces quality of sleep and leaves you feeling tired the next morning.

OSA can affect any age and gender. Research, however, shows that it is more prevalent and more severe in men

OSA have various causes, including the following:

  • Anatomic abnormality. Some people may naturally have large tonsils, a bulky tongue, or a short lower jaw. These features can cause the airway to become blocked and disrupt breathing during slumber.

  • Obesity. Excessive fat deposits in the upper airway can obstruct breathing. Medical conditions usually associated with obesity such as hypothyroidism and polycystic ovary syndrome can also increase your risk.

  • Medications. Sedatives to induce sleep can result in mild or occasional snoring.

How does OSA affect quality of life?

Good sleep is vital for health and well-being. It allows your body to rest and repair, and ensures good function of organs such as heart and brain, and processes such as metabolism and immunity.

OSA disturbs your shut-eye and can increase stress levels, subsequently pushing up risks of ailments such as: 

high blood pressure

High blood pressure

heart disease

Heart disease

heart attack

Heart attack



type 2 diabetes

Type 2 diabetes

One more thing, most people with OSA do not realise they are awakened repeatedly throughout the night. This is likely because they have grown accustomed to the arousal especially since it is very slight. But left untreated, it can disturb sleep patterns and cause sleep quality to deteriorate.

How an ENT specialist diagnoses OSA

Only an ENT specialist can diagnose OSA but it usually requires other medical professionals including dentists and sleep doctors to help you manage it holistically.

Patients fill out a self-administered questionnaire, such as Epworth Sleepiness Score, to identify their potential for sleep apnoea. In addition to weight, height and body-mass index – the correlation of BMI with OSA is high – other medical conditions, if any, will be discussed. These include diabetes, thyroid disease, cardiorespiratory conditions and mental acuity.

Based on your reported symptoms, too, the ENT specialist can perform a polysomnography. It records bodily functions such as brain activity, eye movement and blood oxygen levels as you sleep, to determine if sleep apnoea happens. Some specialists will require you to undergo a Multiple Sleep Latency Test, which measures how fast you fall asleep – 10 to 20 mins if you don’t have any snooze issues. This can be done in your own home.

A sleep nasendoscopy may also be performed. You will be sedated, while a nasendoscope is inserted through the nose. It allows the ENT specialist to examine the back of your nose, soft palate and throat, and further assess how they contribute to the severity of OSA.

How can OSA be treated?

Treatment depends on the root cause(s). Generally, options include weight management, medications, oral devices and surgery. Among the latter is maxillomandibular advancement, which is performed on the upper and lower jaws to increase space behind the palate and tongue base, and offers a positive outcome.