Snoring & Sleep Apnea
Snoring can be a warning sign of a serious medical condition known as obstructive sleep apnea (OSA). It can affect your daytime performance, your job, and your health. Fortunately, there are effective treatments that can reduce or even stop your snoring.
Why Do We Snore?
It is estimated that 45% of normal adults snore occasionally, but 25% are habitual snorers. Heavy snoring is more common in males and overweight persons, and the problem usually grows worse with age.
Snoring is not simply a bad habit that a person can be trained to give up, but it is caused by a partial obstruction of the airway in the back of the throat and nose. The characteristic rattling sound is the vibration of the soft palate and uvula or other structures in the upper airway. This is the result of the airway being constricted by one or more of these physical conditions:
- Poor muscle tone in the soft palate. This may worsen when muscles are relaxed by consumption of alcohol or drugs, or by smoking.
- Enlarged tonsils and adenoids.
- A large uvula and flabby soft palate.
- Blocked nasal air passages, common with a cold or allergies.
- Obstructed nasal airways, caused by polyps, cysts, or a deviated septum.
- Excessive weight, causing tissues in the neck to be bulky and flaccid.
- Hypothyroidism and other glandular disorders.
- Under development of the lower jawbone and retrognatia.
What is Obstructive Sleep Apnea (OSA)?
Snoring can be irritating, problematic, and life threatening. When you snore, you may merely annoy those in the same room, depriving them of sleep. You may be awakened by your own snoring pattern, interrupting your sleep cycle and causing fatigue. Or you may experience the problem in its most exaggerated form, known as obstructive sleep apnea.
Obstructive sleep apnea is an unsuccessful attempt to breathe through the nose and mouth, caused by obstruction that may involve the soft palate, uvula, nose, tonsils, adenoids, or base of the tongue. Obstructive sleep apnea can deprive the snorer of oxygen. If you suffer from obstructive sleep apnea, you are probably also being deprived of the deep sleep stages you need. You may stay sleepy much of the day, and may even fall asleep while driving or working. Research has also associated the condition with high blood pressure, heart attack, and stroke.
Since you cannot determine whether sleep apnea is a problem, your oral and maxillofacial surgeon (OMS surgeon) may recommend a sleep test. The solution may be as simple as managing a nasal allergy or infection, or by reshaping the soft palate with laser treatment.
Snoring and OSA can be treated in a variety of ways since it is a well-known multifactorial problem. There is no “silver bullet to cure OSA but rather a combination of treatments. The OMS surgeon will evaluate your throat, your mouth, your jawbones relationship, and your sinuses, as well as reviewing your sleep study (polysomnogram). Once all the information is gathered, the surgeon will recommend the treatment plan that would fit you best. Sometimes it is best to try a non-surgical approach before any surgery is proposed to rest assured that surgery is your only option. Non-surgical treatment includes the daily use of a continuous positive airway pressure machine (CPAP). Despite this treatment and due to poor patient compliance, most patients end up with one or multiple treatment modalities.
Radiofrequency Induced Uvulopalatopharyngoplasty (RF UPPP)
This procedure is also known as “somnoplasty and is very conservative and minimally invasive. It involves the placement of a small electrode in the patients soft palate that will create a controlled volumetric reduction of the upper airway without the significant risks and high pain levels associated with a conventional palatal surgery. This procedure is performed under local or IV sedation and is successfully completed in less than 15 minutes. The recovery is almost minimal and the patient returns to his/her regular activities in less than 24 hours.
Laser Assisted Uvulo Pharyngoplasty (LAUP)
In some cases, snoring may be best treated with laser surgery known as Laser Assisted Uvulopalatoplasty (LAUP). This surgery, performed in the doctor’s office, uses exacting laser technology to reshape the soft palate and open the airway so you can breathe better during sleep. This laser treatment is generally completed over a series of visits to minimize discomfort to the patient. Pain levels are usually high.
Surgical Uvulopalatopharyngoplasty (UPPP)
This is a very involved in hospital surgical procedure that surgically removes the excess of soft palate. Recovery is lengthy.
Jaw advancements are the most successful and predictable way of resolving OSA. The advancement of the jaws procures a large space in the posterior airway successfully curing the chronic airway obstruction that characterizes this disease.
What Else Can You Do To Decrease Snoring?
Mild or occasional snorers may find relief with the aid of a simple remedy or lifestyle change:
- Avoid heavy meals within 5 hours of going to bed.
- Avoid tranquilizers, sleeping pills, or antihistamines before going to bed.
- Sleep on your side, rather than on your back.
- Raise the head of the bed.
- Avoid smoking.
- Try weight loss and muscle toning.