Upper Airway Anatomy and the Science of Sleep Stages

It's a blend — mostly patients I've already treated referring others after a good outcome, some general awareness through social media, cross-referrals from other departments within Artemis, and GP referrals from outside the hospital, which make up roughly 20 to 30% of this OPD. GPs do a great job fixing the simple presentations themselves; it's when the problem isn't resolving that they refer on.

I haven't read that in any textbook or literature. Chamomile tea is said to calm the nerves and may help, and melatonin helps at night, but wine and alcohol generally disrupt sleep rather than improve it — alcohol causes dryness, and people often don't eat adequately alongside it, leading to a calorie deficit. If anything, it disrupts sleep rather than making it better.

A PAP machine is essentially an airway splint that sends a puff of air to open the blockage at the retropalatal or base-of-tongue level. CPAP delivers one continuous fixed pressure through both inspiration and expiration. BiPAP sets different pressures for each phase — for example 8 cm H2O on inspiration but only 4 cm H2O on expiration — which many patients who can't tolerate CPAP's constant pressure find more comfortable to breathe against.

It could be related to the significant muscle wear and tear from extensive exercise, with the recovery process possibly interfering with sleep — but I have to be honest that I'm not certain about this specifically in athletes, and it would need further looking into.

That's common, and it's physiological. After a hard day, tiredness itself can cause snoring that night, and that's fine — not every episode of snoring has to be branded a pathology. It's only when it becomes chronic and disrupts day-to-day life that it needs to be looked into.

The retropalatal area and the base of the tongue. Obstruction there is classified as either a partial obstruction, called hypopnoea, or a complete one, called apnoea.

Roughly 70 to 75 percent of total sleep.

Growth hormone release peaks, heart rate and blood pressure fall, and the autonomic system shifts from sympathetic to parasympathetic tone. This is the stage where physical recovery happens.

A patient stuck in light N1 and N2 sleep misses this repair window entirely, which drives the early hypertension, arrhythmia risk and neurocognitive impairment seen in poorly sleeping patients.