ASK THE DOC
Surgeon and lecturer Dr Sarah Rayne weighs in on remedies for snoring, vaping versus smoking and the difference between anxiety and a panic attack.
Q: I’ve tried various home remedies to sort out my loud snoring, but to no avail. What could be the cause and what medication can I use?
A: Snoring can affect relationships, the sleep quality of both partners and daytime functioning. Your mouth and throat form a muscular tube, and when you sleep it relaxes, making the gap for breathing smaller and causing those relaxed floppy muscles to vibrate noisily. Snorers can experience short pauses in breathing, which prevent good-quality sleep.
Simple things that increase the ‘floppiness’ of your throat at night are obesity (especially a fat neck), alcohol, smoking and sleeping on your back, so these are the first things to change. Some women start snoring after menopause and find that HRT helps.
Surgery is an absolute last resort for specific anatomical problems (and only after having undergone sleep studies), but there are non-surgical appliances that you could fit at night to support the muscles. A positive-pressure breathing mask can help the worst form of snoring, obstructive sleep apnoea. If simple measures have failed, have a thorough assessment done by an ENT surgeon skilled in this area.
Q: I’m trying to quit smoking and have been told that vaping (e-cigarettes) is healthier than smoking cigarettes – is this true?
A: Smoking is the most common cause of premature preventable death in SA – almost 8 million South Africans smoke 27 million cigarettes a year. Incidents of heart disease, leg amputations and lung cancer would fall dramatically if this practice didn’t exist.
Many think that nicotine is harmful but – although it is addictive – it does little damage on its own. It’s the tar, carbon monoxide and other chemicals in cigarettes that damage your arteries and lungs. So e-cigarettes are an efficient way to feed an addiction yet reduce damage to your health by 95 percent.
While there is some concern that vaping could cause young people to take up smoking cigarettes, there’s little evidence for that. On the other hand, there is considerable evidence that vaping helps people quit smoking cigarettes. I wouldn’t advise non-smokers to take up vaping, but e-cigarettes are a great tool for smokers to modify their habit. There are other methods of quitting, and a combined approach often works best for the long term.
Q: I’ve been experiencing panic attacks over the past few weeks. Is this just normal anxiety or could it be a more serious panic disorder?
A: It’s normal to experience feelings of panic or anxiety. When you feel anxious or threatened, your body reacts instinctively: your heart races and your muscles tense as you prepare to fight or flee – which is useful if you’re running from a lion but less so if you need to deliver a presentation.
Anxiety becomes a problem when panic attacks happen unexpectedly, for no reason or when it stops you doing what you want to – in effect, you develop a ‘fear of fear’. But these attacks aren’t dangerous and will not cause you physical harm.
If you find these attacks intrusive, explore your options with your GP. Talking treatments like cognitive behavioural therapy will help you to understand or manage whatever may be triggering your panic. Some medications can also be helpful while you’re getting on top of things.
In the meantime, there are techniques you can try to avoid an attack or help you cope during one. These include mindfulness, breathing techniques and regular exercise. During an attack, experts suggest acceptance – ‘going with the feelings’ rather than fighting them. Visit the South Africa Anxiety and Depression Group’s website (www.sadag.org) for more information.