I am a 50-year-old lady. For the past few years I have only been able to sleep for about four hours each night.
I had consulted a doctor. She did a sleep study and found that I have obstructive sleep apnoea. An operation was done successfully but the problem of not getting enough of sleep persists. I find myself very tired every morning. Is there any help out there for me?
Dr Stephen Lee, Specialist in Ear, Nose & Throat Surgery, Raffles Hospital
Firstly, I would look at the issue of obstructive sleep apnoea. I would like to know what is the severity of the sleep apnoea condition as determined by the sleep test was done. It is also important to know what type of sleep test was done. There are different types of sleep test, ranging from those of a screening nature to the more complete type of polysomnogram or apnoea graph test. Usually it would be more reliable to rely on a polysomnogram or apnoea graph type study. That aside, if the severities of the obstructive sleep apnoea was of a mild type, then it would be unlikely that obstructive sleep apnoea should be blamed for the inability to sleep just four hours each night.
Assuming that you had a moderate to severe type of obstructive sleep apnoea condition to start with, and as your symptoms of tiredness and feeling weak persist, I would like to investigate to what degree that the obstructive sleep apnoea condition has been improved by the treatment given. I note the comment about the operation being done successfully. However, in this situation, I think that it would be best to assess the success or otherwise of the treatment rendered based on a repeat polysomnogram or apnoea graph test.
If a repeat test were to show that the obstructive sleep apnoea problem were still significant, then it would be necessary to review what we would need to do about the sleep apnoea. A reasonable method would be to give a trial of continuous airway pressure to see if this solves the problem you have described. If it does, then you could choose to continue to use this method of treatment. If however, you still wish to explore alternatives, then it would be worthwhile to carefully assess what has prevented the previous operation from working and to discuss what could be done surgically to correct that.
In the event, that there is no significant obstructive sleep apnoea issue, then I would consider the possibility that this is actually a problem of insomnia. Insomnia can be temporarily helped with medication. However, long-term treatment would usually involve psychological therapy or even Traditional Chinese Medicine.