Obstructive Sleep Apnoea (OSA) is a sleep-related breathing disorder that causes repeated airway blockages during sleep. These interruptions can lead to loud snoring, poor sleep quality, and serious long-term health risks if left untreated.

At Central Sydney ENT, Dr Arjuna Ananda provides specialist ENT assessment and tailored surgical treatment for OSA. With expertise in both nasal and upper airway surgery, Dr Ananda focuses on identifying and correcting the underlying anatomical causes of airway obstruction, especially in cases where CPAP therapy is not effective or tolerated.

Understanding Obstructive Sleep Apnoea

OSA occurs when the muscles at the back of the throat relax excessively during sleep, causing the airway to narrow or close. This can happen dozens or even hundreds of times per night, disrupting normal breathing and reducing oxygen levels in the blood.

Common causes include:

• Enlarged tonsils or adenoids
• Nasal obstruction from a deviated septum, polyps, or enlarged turbinates
• Weak airway tissue that collapses during sleep
• Structural issues involving the jaw, soft palate, or tongue
• Obesity or excess tissue around the upper airway
• Alcohol consumption, particularly in the evening, can relax airway muscles and worsen symptoms

Lifestyle factors such as weight gain, heavy meals before bed, and alcohol use can all exacerbate OSA. In many cases, even modest weight loss (5–10kg) may reduce the severity of symptoms.

In children, OSA is often caused by enlarged tonsils and adenoids, while in adults, the condition may involve multiple anatomical and behavioural factors.

Signs & Symptoms of Sleep Apnoea

Diagnosis and Evaluation

Diagnosis typically involves a combination of symptom review, physical examination, and a sleep study (polysomnography). Dr Ananda works closely with sleep physicians to ensure accurate assessment and diagnosis.

In cases where structural issues are suspected, a nasal endoscopy or imaging may also be recommended to assess the nose and upper airway. Dr Ananda also conducts a combined sleep clinic at Concord Hospital every month, offering collaborative care alongside sleep medicine specialists.

Treatment Options for OSA

Non-Surgical Management

For many patients, non-surgical therapies are the first step:

• CPAP (Continuous Positive Airway Pressure): A machine that delivers air pressure through a mask to keep the airway open during sleep.
• Mandibular Advancement Devices (MADs): Custom-fitted mouthguards that hold the lower jaw and tongue forward to keep the airway clear.
• Lifestyle modifications: Including weight loss, sleep positioning, limiting alcohol before bed, and improving nasal airflow.

ENT Surgical Options

If CPAP or devices are not well tolerated or anatomical causes are clearly identified, surgical intervention may be recommended. Dr Ananda offers a range of evidence-based procedures, including:

• Tonsillectomy & Adenoidectomy: Particularly common in children to relieve airway obstruction.
• Septoplasty & Turbinate Reduction: Improves nasal breathing by correcting structural blockages.
• Uvulopalatopharyngoplasty (UPPP): Removes or reshapes excess tissue in the soft palate and throat to widen the airway.
• Coblation tongue base reduction: A minimally invasive technique that reduces the size of the tongue base and stiffens the soft palate to improve airflow.
• Polyp removal & nasal airway surgery: When polyps or severe nasal congestion contribute to airway resistance.

Each treatment plan is personalised and coordinated with your sleep physician to ensure optimal care and long-term results.

Why Treat Sleep Apnoea?

If left untreated, OSA can increase the risk of:

• High blood pressure
• Heart disease
• Stroke
• Type 2 diabetes
• Chronic fatigue and mood disorders
• Poor academic or workplace performance

Treating OSA can significantly improve sleep quality, reduce health risks, and restore daytime energy, focus, and well-being.