I snore – loudly, apparently – but it’s not sleep apnea. Twenty years ago I tried septoplasty and it helped, but I had a bike accident and damaged my nose, so the snoring came back.
I was offered another operation, but was told it was painful and might not work. Has anything changed in the snoring department since then? I’m 58, 5ft 8, 11th and really fit – cycling 15 miles a day.
Grog Fookes, Woking, Surrey.
Snoring is often caused by obstructive sleep apnea, where throat tissue temporarily collapses during sleep.
One of the main risk factors is weight gain, but at 11 this doesn’t apply to you, and indeed sleep apnea has been ruled out (which is good news, as it’s linked increased risk of heart attack or stroke).
Smoking and drinking too much alcohol are also known to increase the risk of snoring – smoking can cause congestion in the nasal passages and alcohol relaxes the throat muscles – so reducing both can help.
Snoring is often caused by obstructive sleep apnea, where throat tissue temporarily collapses during sleep
Sleeping on your side can also be beneficial, as it can reduce the tendency of the tissues at the back of the roof of the mouth, the soft palate, to collapse and cause intermittent obstruction. The air you breathe out causes the tissues to vibrate, causing snoring.
The operation you had all those years ago is to straighten the septum, the bony cartilage that separates the nostrils. A deviated (or twisted) septum is a common cause of snoring. Although this operation is not so much in favor anymore (evidence that improving the airways in both nostrils can help with snoring is lacking), the fact that it originally worked for you suggests that the internal structure of your nose may be a factor.
I suspect the second operation you were offered was uvulopalatopharyngoplasty (UPPP) surgery, where the tissue at the back of the throat, often including part of the soft palate, is cut.
Although research shows it can reduce the intensity of snoring, long-term studies do not confirm this – the results do not appear to be permanent.
Knowing that snoring is common, affecting more than 40% of men and nearly 30% of women between the ages of 30 and 60, is it essential to pursue a resolution?
The potential complications and post-op pain, which are legendary, also prohibit having this surgery, so I have a feeling you were right to avoid it.
There are newer procedures, such as radiofrequency ablation, which uses heat rather than a scalpel to shrink the volume of the soft palate.
It has been shown to be a safe and effective way to reduce snoring (with less postoperative pain than UPPP), although the duration of benefits is unclear.
Palatal implants consist of implanting polyester fibers in the soft palate to stiffen it. Although it also reduces snoring, the long-term results are even less certain.
As you can see, there is nothing magical or new that can easily resolve your symptom.
Knowing that snoring is common, affecting more than 40% of men and nearly 30% of women between the ages of 30 and 60, is it essential to pursue a resolution?
As long as sleep apnea has been ruled out, you may be advised to accept the situation.
My friend hit his head in the bath recently and has since had blurry vision, is wobbly on his feet and has been throwing up. He refuses to go to the hospital, what can I do?
Eloise Few, Notting Hill, London.
Your friend may need a head scan. The symptoms you describe—along with fatigue, dizziness, loss of balance, mood swings, and slurred speech—may indicate underlying brain damage.
Even a minor blow to the head can cause problems such as a concussion, intracranial hematoma (when a blood vessel ruptures and blood collects in the tissues) and cerebral contusion (a localized bruise in the brain).
Much depends on one’s age – older people’s brain tissue is more susceptible to damage from even a minor impact.
Your friend may need a head scan. The symptoms you describe – along with fatigue, dizziness, loss of balance, mood swings and slurred speech – may indicate an underlying brain injury
If symptoms persist, especially if his mood changes or he continues to be unsteady on his feet, try to persuade him to seek medical advice.
I am almost 80 years old, I am in great shape and I work in the laundry room of a retirement home. I’m 5ft 2in and have always been very thin, but I’m currently around 7th and worried that I’m too thin because everyone seems to think I’m sick.
Madeline Kelly, East Sussex.
Your body mass index, a number that combines weight and height, is at the lower end of the healthy range – so I see no reason to worry.
But there are things you can do if you’re worried.
You say in your long letter that you have always had a small appetite and have always been active.
Add to that sarcopenia — the inevitable, gradual muscle loss over time (after age 30 you lose between 3-5% muscle every ten years) which will inevitably lead to weight loss, because muscle is three times as heavy as fat.
You can minimize this muscle loss by eating more protein (meat, fish, and eggs) and exercising regularly. Omega-3 fatty acids also stimulate muscle growth; fatty fish like canned mackerel or sardines are a good source.
In terms of exercise, try lifting weights of around 2kg to 3kg for 30 minutes three times a week.
Write to Dr. Scurr
Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London W8 5HY or email: drmartin@dailymail.co.uk – include contact details. Dr. Scurr cannot maintain personal correspondence. Answers should be taken in a general context. Consult your own GP for any health concerns
In my opinion… Grant tax relief on private GP consultation fees
The Prime Minister was widely criticized for initially refusing to say whether he had a private GP.
He eventually told the House of Commons he did in fact have an NHS GP – three days after dodging the question in an interview. I really don’t understand his reluctance to reveal it.
We all have the right to pay for medical care outside the NHS, and many do – cosmetic surgery being a prime example.
Margaret Thatcher did not hesitate to call on a private general practitioner, just like the pope during his visit to the United Kingdom in 1982 (that private doctor was me!). In my private practice, I have also seen Labor MPs and peers who have no problem getting out of the NHS, despite their proclaimed ideology.
When I was an internal surgeon at Westminster Hospital in 1972, Marcia Falkender, secretary to Labor leader Harold Wilson, was treated in our unit in a private room.
Harold Wilson’s government then decided to abolish chargeable beds in NHS hospitals.
Whatever his stance, Rishi Sunak should allow tax relief on the cost of a private GP consultation to reduce pressure on the NHS.
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