Snoring - The Noisy Nightmare!
Eight to 10 years ago, snoring was regarded as a strictly cosmetic issue - people are just loud when they sleep. Today, however people realized that snoring is also a medical issue. Snoring is a very common sleep disorder that can be bothersome to the snorer's family or friends, but may actually be the first sign of a more serious sleep disorder
Causes of Snoring
Snoring is caused by vibrations of portions of the upper airway during sleep. There are two structures that usually are the source for the noise: the soft palate and the base of the tongue. The major concern with is that obstructive sleep apnea (OSA) is very common in people who snore. OSA can have serious health consequences if it is untreated. If your spouse snores, you should closely observe him or her at night to see if there are breaks or pauses in breathing. This is a typical finding in OSA. Another sign of OSA is daytime somnolence. If either of these are present, or if the snoring is excessively loud, you should definitely bring it to your doctor's attention. The etiology and risk factors for snoring are very similar to those of OSA, so the discussions on that disorder linked above will overlap much of the information given here. Snoring is known to be more common in overweight individuals. Difficulty breathing through the nose can worsen snoring. Certain anatomic features, like large tonsils, a large soft palate, or (most often in children) large adenoids can worsen snoring.
Treatment for Snoring
Before treatment for snoring can be considered, it is important to determine if significant sleep apnea is present. This usually requires an overnight sleep study. Treating the sleep apnea usually also will correct the snoring. Since there can be health consequences of untreated sleep apnea, this take priority. If only snoring is present, it is actually treated using methods similar to treatment of mild sleep apnea. Losing weight, even a small amount, can be quite effective in reducing snoring. If nasal obstruction is present, anything that improves nasal airflow may reduce snoring. Nasal swelling can occur with allergies, and a variety of different medications can be effective. If there is a deviated nasal septum, a septoplasty may be helpful. Various pillows or other tricks to help reposition the snorer may be useful. Snoring is usually worse on one's back, so anything that encourages the snorer to sleep on his or her side can help out. Compliance may be a problem with anything that is uncomfortable or impractical.
Surgical Treatments for Snoring
Various surgical techniques can be useful in reducing the severity of snoring. These procedures do not eliminate snoring, but may make it less loud so is better tolerated by the snorer's bed partner. Snoring is most often caused by fluttering of the soft palate, so the goal of the operations is to stiffen up the palate and prevent this movement.
Laser Assisted Uvulopalatoplasty is an outpatient procedure in which a " linear cut on either side of the uvula, and may trim a portion of the uvula. As this incision heals, it causes some scarring of the back of the palate. This shortens the palate and reduces it tendency to vibrate. A LAUP is generally not felt to be sufficient for severe sleep apnea, but seems to help in mild cases.
Similar in principle to a LAUP is somnoplasty. Somonoplasty is a new procedure that uses radio frequency energy to heat tissue in the palate, causing formation of a lesion that gradually scars down and reduces the size and floppiness of the palate. The improvement is not immediate, but rather develops gradually over three to six weeks. The handpiece to deliver the energy for somnoplasty has a thermocouple that keeps the temperature at just the right level during treatment. Three regions of the palate are typically treated at one time, and improvements are often seen after just one treatment. Somnoplasty is also an outpatient procedure and is quite a bit less painful than a LAUP.
Some insurance companies do not pay for the treatment of snoring as a distinct, isolated problem. Some patients undergo sleep studies, which confirm the severity of their sleep disorder, thereby rendering treatment insurable. In most cases, snoring is caused by several anatomic factors that jointly block the airway during sleep. Correction of these factors, such as nasal obstruction, enlarged tonsils and abnormalities of the palate, is covered by insurance.
An initial consultation with an ear, nose and throat specialist will help determine which treatment/s is right for you. Don't ignore the snore! Call 1-800-973-NOSE (6673).