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Results from nasal surgery for snoring questionnaire

The Labour Leader Ed Milliband is said to be suffering from sleep apnoea. This is a condition characterised by loud snoring interrupted by episodes of complete cessation of breathing. These episodes of not breathing, known as apnoeas, occur constantly throughout the night. Apnoeas are the result of a narrowing or complete closure of the airway and consequently air is prevented from reaching the lungs. The brain automatically wakes the sufferer so that the airway can resume its muscle tone and return to normal breathing. These awakenings or arousals as they are known are so short the sufferer is not usually conscious of them occurring. However, the consequence of frequent arousals during the night is excessive daytime sleepiness. In the case of Ed Milliband however is appears that his doctors have cited his adenoids and a deviated nasal septum as the cause of his sleep apnoea. His doctors are planning to remove his adenoids and to straighten his septum in the hope that it will resolve the problem.

There is a number of surgical treatments available for treating nasal problems that often contribute or exacerbate snoring. However, it has been difficult to find clinical evidence that nasal surgery is successful in resolving snoring. In view of this, The British Snoring & Sleep Apnoea Association conducted a survey to discover how other sufferers of snoring and sleep apnoea viewed the benefits of nasal surgery for snoring.

The survey conducted in June 2011 comprised 300 participants who had undergone a nasal procedure in the hope of alleviating their snoring and/or sleep apnoea.

Nasal procedures comprised: Septoplasty, SMD (Sub Mucous Diathermy), Turbinectomy, Polypectomy and Sinus Surgery.

Of the 300 participants, 80% were male and 20% female ranging in age from 25 - 88 years. Average age of participants was 44 years.

The average age at time of surgery was 42 years with 68% of participants having snored for more than 5 years prior to surgery. Of the nasal procedures, 73% of participants underwent septoplasty.

When asked if nasal surgery stopped their snoring, 79% of participants said no, 14% said initially but snoring resumed and 7% said yes.

For those whose snoring was resolved with surgery, other benefits such as better breathing and better sleep were also cited.

Of those participants whose snoring was initially resolved, 35% reported that snoring resumed within 12 weeks and 50% reported snoring resumed within 6 months. Following surgery 52% of participants reported snoring to be no more or less than prior to the procedure, 37% slightly less than before, and 10% reported that snoring was worse than before.

When asked whether participants had now stopped snoring through other means, those for whom surgery was unsuccessful, 82% of them said they had found other resolutions to their snoring. For those for whom surgery initially resolved the problem but snoring resumed, only 75% of these participants have now stopped snoring through other means. Interestingly, 40% of participants who have stopped snoring through other means, have done so using CPAP (Continuous Positive Airways Pressure) and 37% have found success using a MAD (Mandibular Advancement Device) to stop their snoring.

In conclusion the success of nasal surgery for snoring is usually quantified by the level of snoring noise. In this study, the results overwhelmingly report that nasal surgical procedures have not been successful in 93% of cases. For the remaining 7% who felt their snoring had been resolved, they also indicated that they now experience better breathing and better sleep.

In view of this, it could be concluded that nasal surgery for the purpose of stopping snoring is not successful. But, a small minority of patients may benefit from other improvements such as improved nasal breathing that will allow them to better tolerate the use of other treatments to stop the snoring. There is generally no cure for snoring and sleep apnoea, but at best, the symptoms can successfully be controlled with appropriate treatments.

As for Ed Milliband, only time will tell whether his nasal surgery has been successful in resolving his sleep apnoea. In view of current clinical evidence regarding a 'cure', this seems unlikely. But we are still left wondering whether Ed Milliband, like most sufferers of sleep apnoea, is experiencing the most common symptoms of loud snoring and daytime sleepiness. Perhaps we should keep a vigilant eye for him nodding off during Prime Ministers Question Time.