I’ve been snoring for years…can surgery cure me? DR MARTIN SCURR answers your health questions

I snore – loudly I believe – but it’s not sleep apnea. Twenty years ago I tried a septoplasty and it helped, but I fell on my bike and ruined my nose so the snoring came back.

I was offered another operation but was told it was painful and might not work. Has anything changed in the snoring department since then? I’m 58.5ft 8″, 11″ and really fit – I ride 15 miles a day.

Grog Fookes, Woking, Surrey.

Snoring is often caused by obstructive sleep apnea, in which the tissues in the throat temporarily break down during sleep.

One of the main risk factors is weight gain, but first of all, this does not apply to you, and sleep apnea is actually excluded (which is good news, since it is associated with an increased risk of heart attack or stroke). .

Smoking and excessive alcohol consumption are also known to increase the likelihood of snoring – smoking can cause nasal congestion and alcohol relaxes throat muscles – so cutting down on both can help.

Side sleeping can also be beneficial as it can reduce the tendency of tissue at the back of the palate, the soft palate, to collapse and cause intermittent obstruction. The exhaled air vibrates the tissue and creates the sound of snoring.

The surgery you had all those years ago involves straightening the septum, the bony cartilage that separates the nostrils. A deviated (or curved) septum is a common cause of snoring. Although this surgery is not as popular anymore (evidence that improving the airways in both nostrils can help with snoring is lacking), the fact that it worked for you initially suggests that the internal structure of your nose may be a factor .

I suspect the second operation you were offered was an uvulopalatopharyngoplasty (UPPP), which involves removing tissue in the back of the throat, often including part of the soft palate.

While research shows that it can reduce the intensity of snoring, long-term studies do not support this – the results do not appear to be permanent.

Considering that snoring is very common, affecting more than 40 percent of men and nearly 30 percent of women between the ages of 30 and 60, is it important to find a solution?

The possible complications and postoperative pain, which are legendary, also speak against this operation, so I think you were right to avoid it.

There are newer procedures, such as radiofrequency ablation, that use heat instead of a scalpel to reduce the volume of the soft palate.

It has been shown to be a safe and effective method of reducing snoring (with less post-operative pain than UPPP), although it is not clear how long the benefits last.

In palatal implants, polyester fibers are implanted into the soft palate to stiffen it. It also reduces snoring, but the long-term results are less certain.

As you can see, there is nothing magical or new that can easily solve your symptom.

Considering that snoring is very common, affecting more than 40 percent of men and nearly 30 percent of women between the ages of 30 and 60, is it important to find a solution?

As long as sleep apnea is ruled out, it is best to accept the situation.

My friend recently hit his head on the tub and since then has had blurred vision, unsteady on his feet and throwing up. He refuses to go to hospital – what can I do?

Eloise Few, Notting Hill, London.

Your friend may need a CT scan of his head. The symptoms you describe—along with fatigue, dizziness, loss of balance, mood swings, and slurred speech—could indicate an underlying brain injury.

Even a minor blow to the head can lead to problems such as concussion, an intracranial hematoma (when a blood vessel bursts and blood pools in the tissue), and a cerebral contusion (a localized bruise in the brain).

Much depends on age – the brain tissue of older people is more susceptible to damage from even a minor impact.

Your friend may need a CT scan of his head. The symptoms you describe – along with fatigue, dizziness, loss of balance, mood swings and slurred speech – could indicate an underlying brain injury

If symptoms persist, especially if his mood changes or he remains uncertain, try to persuade him to see a doctor.

I am almost 80, very fit and work in a nursing home laundry room. I’m 5ft 7″ and have always been very slim, but I’m currently about 7st and worried that I might be too skinny because everyone seems to think I’m sick.

Madeleine Kelly, East Sussex.

Her body mass index, a number that combines weight and height, is at the lower end of the healthy range – so I don’t see anything to worry about.

But there are things you can do if you’re worried.

You say in your longer letter that you have always had a small appetite and have been active.

Add to that sarcopenia — the inevitable and gradual loss of muscle mass over time (after the age of 30 you lose between 3 and 5 percent of muscle mass every decade), which inevitably leads to weight loss as muscle becomes three times the weight of fat.

You can reduce this muscle loss by eating more protein—meat, fish, and eggs—and exercising regularly. Omega-3 fatty acids also stimulate muscle growth; oily fish such as canned mackerel or sardines are good sources.

Aim to lift weights of around 2kg to 3kg for 30 minutes three times a week.

Write to Dr. scramble

Write to Dr. Scurr to Good Health, Daily Mail, 9 Derry Street, London W8 5HY or email: drmartin@dailymail.co.uk — add contact details. DR Scurr cannot respond to personal correspondence. Answers should be taken in a general context. If you have health problems, contact your GP

In my opinion… Give tax breaks for reimbursements to see a private GP

The prime minister was widely criticized for initially refusing to say whether he had a private doctor.

He finally told the House of Commons that he did have an NHS GP – three days after dodging the question during an interview. I really don’t understand his reluctance to disclose this.

We all have the right to pay for healthcare outside the NHS and many do – cosmetic surgery is a good example.

Margaret Thatcher did not hesitate to consult a private GP, as did the Pope when he visited Britain in 1982 (that private doctor was me!). In my private practice I have also seen Labor MPs and colleagues who, despite their proclaimed ideology, have no problem leaving the NHS.

In 1972, while I was a resident at Westminster Hospital, Marcia Falkender, secretary to Labor leader Harold Wilson, was treated in a private room on our ward.

Harold Wilson’s government later wanted to end paid beds in NHS hospitals.

Regardless of his own position, Rishi Sunak should give tax breaks on the cost of seeing a GP privately to ease the burden on the NHS.