Search

Sleep nasendoscopy was conceived at the Royal National Throat, Nose and Ear Hospital, UK in 1991, and has remained fully implemented in patient selection for targeted treatment of the spectrum of sleep-disordered breathing. The senior authors (B.T.K. and P.B.) have been performing sleep nasendoscopy together for over 10 years, and we look back at their decade’s experience. A retrospective audit study based on case notes was performed over a 10-year period (1995–2005) in a tertiary-referral practice setting. Case notes were retrieved on all patients who had undergone sleep nasendoscopy during the study period, and agreed data were extracted and analyzed. A total of 2,485 sleep nasendoscopies were performed in patients with a mean age of 44.1 years, a 4:1 male preponderance, and a mean body mass index of 27.3 kg m−2. Sleep nasendoscopy grading correlated well with apnoea–hypopnoea index and mean oxygen desaturation. Such grading helped us define and discuss treatment options with patients. After a median follow-up period of 518 days, 72% of patients reported feeling better; 26% of patients reported no change; and only 2% of patients reported feeling worse after treatment. Sleep nasendoscopy has proved to be a useful adjunctive method to identify the anatomical site of snoring, not to mention upper airway collapse, and remains integral to our tertiary-referral practice. It has allowed us quality assessment of the dynamic anatomy of sleep-disordered breathing that most closely and cost-effectively simulates the natural situation of patients. And for targeted treatment, such assessment has been fundamental. [ABSTRACT FROM AUTHOR]

Study Objectives: (1) To determine the prevalence of snoring, breathing pauses during sleep and obstructive sleep apnoea syndrome in the United Kingdom (UK) and determine the relation between these events and obesity and other sociodemographic variables. (2) To compare and integrate this data with published UK population data., Methods: A total of 664 women and 575 men aged 18-100 years who formed a representative sample of the non-institutionalised UK population participated in an online interview survey directed by a previously validated computerised system., Results: Overall, 38% of men and 30.4% of women report that they snore at night. Furthermore, 8.7% of men and 5.6% of women state that they stop breathing at night. Comparing our data to published data from the 1990s, this study observes a highly significant increase in the rates of reported breathing pauses during sleep (sleep apnoea) in the UK over the last 20 years (p < 0.0001). In addition, we observe a highly significant increase in the prevalence of obesity (BMI>30) in the UK population between 1994 and 2015 (p < 0.0001). Integration of our data with NHS and public health England data on obesity confirms this increase., Conclusions: Our data demonstrate a significant increase in the rates of reported breathing pauses during sleep (sleep apnoea) and obesity in the UK over the last 20 years. Sociodemographic and behavioural changes have likely contributed to this. Moreover, our data also suggests that sleep disordered breathing (SDB) is widely underdiagnosed in the UK., (Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.)