Sleep & Snoring Services
- The British Sleep & Snoring Centre
- What are sleep related breating disorders?
- What is available to help with disorders?
- Costs
The British Sleep & Snoring Centre
The British Sleep & Snoring Centre is based at St Jude’s Hospital and provides a complete diagnostic and treatment facility for patients with snoring and sleep related breathing disorders including sleep apnoea.
The service is provided by three ENT surgeons, a Respiratory Physician, a Maxillofacial Surgeon and an experienced nurse.
The clinic is fully equipped to undertake diagnostic ENT examination using the latest video-nasendoscopy equipment which provides video replay of the assessment so that as a patient you can directly observe the areas of the nose and throat which appear to be causing obstruction.
We have the latest in sleep diagnostic equipment in the Apneagraph. This overnight assessment is done at home and does not require admission to hospital. It involves placing of a thin wire into the nose and throat which is secured into position with tape on the face. This is setu p at St Jude’s in the early evening and removed the following morning.
An ApneaGraph
The Apneagraph assesses the level of obstruction in patients who snore or have sleep apnoea. It provides accurate assessment of sleep related breathing problems and will determine the severity of sleep apnoea syndrome is present and the level of obstruction causing snoring.
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What is sleep related breathing disorder?
There are a group of conditions that lead to a disturbed sleep pattern and as a consequence a reduction in general well being and possible underperformance at work and at home.
Sleep related breathing disorders (SRBD) include primary snoring also known as simple snoring; upper airways resistance syndrome and obstructive sleep apnoea.
Snoring is caused by vibration of soft tissue in the upper airway in areas of constriction. In order to improve the outcome from surgery for snoring and sleep apnoea, the Apneagraph forms an essential part of the assessment in most patients.
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What is available to help with SRBD?
Many treatments are available for SRBD depending on the cause.
a) In some cases simple measures such as weight reduction, changes in lifestyle or regular sleep and wake cycles are all that is needed.
b) Oral Splints act to bring the bottom jaw forward during sleep. As a result of this there is a reduction in collapse and vibration of the tongue base. These can usually be made by your dentist, alternatively some “home made, boil in the bag” splints are available.
c) Nasal surgery in the case of nasal pathology such as nasal polyps and deviations in the nasal septum (the partition in the nose) lead to significant improvement in symptoms.
d) Coblation using a palatal wand, can be used to reduce the bulk of the palate. It can also be used for “palatal channelling” where a series of scars are created in the palate beneath the mucous membrane in order to provide scar tissue within the palate leading to stiffening of the palate and therefore reduced movement. This can be done under local anaesthetic as an outpatient procedure. The same device can also be sued to reduce the bulk of the tongue base which can also be a significant cause of snoring. This latter procedure is usually carried out under a general anaesthetic.
e) Pillar Implants are also available to stiffen the palate. In this procedure three polyethylene implants are placed under the lining membrane of the palate into the muscle of the palate. This has the effect of stiffening the palate.
Results of this procedure and coblation channelling in terns of reduction of snoring are similar, however, the implants may come out in about 1 in 10 implants. The procedure can be repeated.
f) Laser can also be sued to scar and stiffen the palate. This generally is associated with more postoperative pain than the previous two procedures.
g) Uvulopalatopharyngoplasty (UPPP) has been used for many years. It is a more aggressive form of surgery to the palate and throat. It may involve the removal of tonsillar tissue and tissue from the palate. This procedure is usually carried out under general anaesthetic. It usually requires time away from work for recovery to take place.
h) Other procedures can be required depending on the level of obstruction. These may include surgery to the upper or lower jaw; tongue reduction or suspension procedures. These are clearly a major undertaking and are required by only a small number of patients.
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Costs
| Summary: | |
|---|---|
| Initial consultation, including Epworth sleepiness score, ENT assessment and video-nasendoscopy | £190 |
| Apneagraph, including fitting and removal of device, rental of device, analysis and follow up consultation | £350 |
| Coblation under local anaesthetic | £750 |
| Pillar Implants under local anaesthetic | £1050 |
| Laser surgery under local anaesthetic | £980 |
| Other procedures and general anaesthetic cases | Priced individually |