“Snoring and sleep apnoea” is a dangerous and reasonably common disease, originating from various causes. Therefore, the examination and treatment process requires a multidisciplinary approach to achieve optimal effectiveness. In Can Tho on 20^th July, 2024, FV Hospital, in collaboration with Can Tho ENT Hospital and with the consultation of Thomson Medical Group (Singapore), organised the “Comprehensive Approach for Treatment of Snoring and Sleep Apnoea Syndrome” CME Training Programme. The training programme featured speakers who are specialists in ENT, maxillofacial surgery, general surgery, and nutrition. Notably, it included a presentation by Dr Barrie Tan, a renowned ENT Specialist from Singapore.

The training programme attracted more than 300 doctors specialising in maxillofacial surgery, ENT, general surgery, and nutrition from 25 hospitals across Can Tho, Ca Mau, Ben Tre, An Giang, Tien Giang, Soc Trang, Tra Vinh, Vinh Long, Long An, Kien Giang, and Dong Thap. The programme garnered much interest and high praise for its professionalism in organisation and the quality of the presentations from the participating doctors, with Dr Barrie Tan’s presentation standing out in particular.

The programme marks the beginning of FV Hospital’s strategy to “Bringing Singaporean Medicine to Vietnam” after FV became a member of Thomson Medical Group (Singapore).

“The participation of guest speaker – Dr Barrie Tan, an ENT specialist from Gleneagles Hospital (Singapore), at the training programme “Comprehensive Approach and Treatment of Snoring and Sleep Apnoea Syndrome” organised by FV in Can Tho is one of our initial efforts in the plan to invite top experts and doctors from Singapore to Vietnam,” said Vu Truong Son, MD, MSc, Deputy Medical Director of FV Hospital.

According to Dr Jean-Marcel Guillon, Chief Executive Office of FV Hospital, “The presence of Dr Barrie Tan, a renowned ENT specialist from Singapore, at this training programme demonstrates our commitment. We have selected and invited top Singaporean experts to FV not only to train and enhance the professional quality and patient care through participation in scientific activities that transfer advanced technologies being applied in Singapore, but also to consult, diagnose, and treat patients in Vietnam.”

At this training programme, experts presented several new and comprehensive treatment methods for the dangerous condition of “snoring and sleep apnoea.” This programme is part of a series of continuous medical education activities organized by FV Hospital, where participating doctors will receive official certificates and credits in accordance with the regulations.

Sleep Apnoea: Tripled Mortality Risk, Multidisciplinary Approach Needed for Accurate Treatment

In his presentation, Vo Cong Minh, MD, PhD, Head of the ENT Department at FV Hospital, revealed a recent statistic that shows 8.5% of Vietnam’s population suffer from sleep apnoea. This is a dangerous condition, if left untreated and can lead to numerous complications such as hypertension, diabetes, cardiovascular disease, stroke, increased rates of workplace and traffic accidents, reduced quality of life, and a tripling of mortality risk over 15 years.

Vo Cong Minh, MD, PhD, emphasised that sleep apnoea originates from various causes, including lifestyle changes, overweight, obesity, and other chronic conditions. Therefore, optimal treatment requires a multidisciplinary and multifaceted approach. For obstructive sleep apnoea, patients should first be screened and evaluated for upper airway issues by ENT specialists through polysomnography, conducted within 12 months, or comprehensive ENT examinations and endoscopy. Other diagnostic methods may include X-ray, fluoroscopy, CT scan, MRI, cephalometric analysis, or the latest CT scan cone beam 3D method, which allows for volumetric measurements of the entire upper airway – a new technology recently implemented at FV Hospital. Based on screening results, doctors will use the Apnoea-Hypopnea Index (AHI) to determine whether the patient requires surgery or medical treatment.

Dr Minh was proud to announce “In the near future, FV will introduce a technique called upper airway neuromuscular electrical stimulation for the treatment of sleep apnoea.”

Another cause of sleep apnoea can be abnormal jawbone structure (retrognathia), which narrows or obstructs the airway during sleep. Thus, treating this condition may require the involvement of maxillofacial surgery specialists. Nguyen Thanh Tung, MD, PhD, Head Oral & Maxillofacial Surgery – Dental Surgery at FV Hospital, presented maxillofacial Surgery & Dental Intervention in the treatment of Sleep Apnoea Syndrome. According to Dr Tung, patients may be prescribed dental devices to advance the lower jaw forward during sleep to prevent the lower jaw from causing airway obstruction. This approach is typically recommended for cases of primary snoring, mild to moderate sleep apnoea, and sleep apnoea or snoring related to sleep position.

For more severe cases, patients may be recommended for surgery using the technique of maxillary and mandibular osteotomy, where the upper and lower jaw bones are advanced forward. This method has shown to be highly effective in stabilising the pharyngeal wall compared to other interventions involving the pharyngeal area. The success rate of this surgery is very high, reducing the AHI (Apnoea-Hypopnea Index) from 33.9 to 9.5, with a success rate of about 86% and a complete recovery rate of 30-40%

At the training programme, Specialist Level II, Nguyen Viet Quynh Thu, MD, MSc, Head of Dietetics & Nutrition Department at FV Hospital, shared insights and expertise from the field of nutrition regarding this condition. Dr Thu noted that obesity is a major factor for obstructive sleep apnoea (OSA). For every 10% increase in body weight, the risk of OSA increases six fold. Therefore, weight loss is crucial and can significantly reduce the severity of sleep apnoea. To treat sleep apnoea, obese individuals should follow a balanced diet, engage in regular exercise, and use medication if necessary.

In cases where patients have a high Body Mass Index (BMI) (BMI > 35 or BMI > 30 with multiple comorbidities), and weight reduction through diet, exercise, and medication is not effective, surgical methods such as gastric bypass surgery may be considered. According to Specialist Level II, Phan Van Thai, MD, MSc, (Head of General Surgery Department, FV Hospital), a study involving 14,000 patients who underwent gastric bypass surgery for weight loss showed a significant improvement in sleep apnoea, with rates ranging from 77% to 86%.

FV is one of the pioneering hospitals to perform sleeve gastrectomy. From January 2017 to December 2023, FV successfully completed 31 cases. The follow-up data for 12 months shows that the average BMI was 37.5 before surgery, and decreased to 25 after 12 months. Three months post-surgery, the average weight loss was 20 kg, and after 12 months, the average loss was 35 kg. “For patients with sleep apnoea and obesity, six months post-surgery, 3 out of 4 no longer required positive airway pressure machine for sleep, and after 12 months, all 4 patients no longer required the machine,” says Dr Thai.

According to the experts at the training programme, sleep apnoea is caused by various factors and requires accurate airway assessment and multidisciplinary collaboration for effective treatment. FV Hospital, with its international standard multidisciplinary approach, that integrates the ENT Department, Dietetics & Nutrition Department, and General Surgery Department for comprehensive management of this condition. Furthermore, as a member of the Thomson Medical Group, FV benefits from the on-going support and collaboration with top experts from Singapore to enhance its ENT treatment capabilities. Notably, in the near future, leading experts and doctors from Singapore will come to FV to directly treat patients in Vietnam.

Through the strategy of “Bringing Singaporean Medicine to Vietnam” FV is actively sharing new knowledge with the Vietnamese medical community, contributing to the advancement of medical care in Vietnam.

At this CME training programme, Dr Barrie Tan, a renowned ENT from Gleneagles Hospital, Singapore, presented “Advanced Ear Surgery and Hearing Implants – Latest Technology and Trends.” Dr Tan provided updates on advanced techniques in treating hearing disorders. His presentation was highly valued as this field is still relatively new in Vietnam.

Dr Barrie Tan’s significant participation underscores FV Hospital’s commitment to its strategy of “Bringing Singaporean Medicine to Vietnam”

At the training programme, on behalf of FV Hospital’s Board of Directors, Dr Vu Truong Son commented: “Since merging with Thomson Medical Group, we have had the opportunity to invite top experts and advanced techniques from their network to update not only FV doctors but also the Vietnamese medical community with new skills and cutting-edge techniques from their country. In the near future, many Singaporean doctors will join our team at FV to continue our mission of bringing international medical services to Vietnamese patients.”

The attending doctors showed significant interest and highly valued the comprehensive approaches to treating snoring and sleep apnoea. After the conference, participants took an exam and were awarded continuous medical education (CME) certificates by FV Hospital.

Chau Chieu Hoa, MD, PhD – Director of Can Tho ENT Hospital & President of Can Tho ENT Association, commented: “FV Hospital has a significant impact both nationally and internationally, having organised numerous professional events to exchange experiences among doctors across the country. This event is extremely important for the healthcare sector in Can Tho and neighbouring provinces. The CME certification provided by FV Hospital is crucial as it helps participating doctors gain additional medical knowledge and strengthen their expertise.”