A thorough examination by our physicians is necessary to help determine the true cause of snoring.
More than 5 percent of the adult population suffers from significant sleep apnea, a serious medical problem that occurs in a sleeping person when the throat and upper airway become blocked. The muscles in the throat and neck may relax, thereby creating an increased laxity and floppiness of the tissues. These tissues may actually collapse the airway, creating a breathing obstruction and one must actually wake up slightly to tighten the tissues to allow breathing to continue. This cycle of repeated awakening can happen hundreds of times to the same person each night. More frequent cycles and longer breathing pauses are usually associated with more severe apnea symptoms.
The possible signs of sleep apnea include: gasping or snorting during sleep, waking up tired after a full night’s sleep, morning headaches, daytime fatigue and sleepiness, ability to fall asleep very quickly, memory and concentration problems, attentiveness trouble, irritability and childhood behavioral problems. Sleep apnea can increase the risk of developing high blood pressure, heart problems, strokes and depression. It also can increase the risk of motor vehicle and heavy machinery accidents.
Snoring is not only an annoying problem, it can also be a sign of sleep apnea. Forty-five percent of adults snore at least occasionally and twenty-five percent are habitual snorers. It can stress and strain many relationships and marriages; some even end due to snoring. Snoring usually is caused by redundant tissue in the soft palate and tongue. The nose and nasopharynx behind the nose also can play a role. A thorough examination by one’s physician, often utilizing endoscopic techniques, is necessary to help determine the true cause of snoring. Sleep testing is important for people who snore and who exhibit symptoms of sleep apnea or experience irregular breathing events while sleeping.
Treatment for sleep apnea can involve both conservative measures as well as surgery for those with persistent symptoms. Conservative measures include weight loss, healthy diet and exercise, and alcohol, antihistamine and sedative avoidance. Apnea sufferers should sleep on the side rather than on the back, and raise the head of the bed 6 inches; dental appliances and splints may also be of help. Those who have persistent problems despite these measures may benefit from surgery, including palatal procedures both in office and hospital to reduce the size and stiffen the soft palate, and office procedures performed under local anesthesia with an FDA-approved temperature-controlled radiofrequency device.
The “gold standard” procedure is the Uvulopalatopharyngoplasty, (UPPP) during which a portion of the soft palate is removed and tightened with dissolvable sutures. The tonsils, if present, are often removed at this time. This procedure, performed under general anesthesia in the operating room of the hospital, usually completely eliminates the snoring and often greatly improves the apnea. Ancillary procedures such as radiofrequency reduction of the tongue base as well as nasal septoturbinoplasty to assist in nasal breathing, can also be required to achieve the best results.