Snoring

Has snoring affected your bedroom harmony?

Snoring / OSA

Snoring and other Sleep Disordered Breathing:

Extremely common affecting 24% of Male and 9% of Female Adults in the United States to a degree where it interferes with their lifestyle.
75 Million Americans suffer from some sort of sleep disordered breathing and of those approximately 1 million are diagnosed with sleep apnea every year.

Contributing Causes:

  • Anatomy of the Nose and Throat
  • Obesity
  • Lifestyle particularly the consumption of Alcohol.
  • Aging which decreases tissue elasticity

Snoring:

Noise caused by upper airway resistance. Usually produced in the soft palate and / or Uvula. May also be produced by the back of the nose or tonsils and tongue. Treatments to decrease snoring focus on the removal of these anatomic structures. This reverses the loss of elasticity caused by aging.

Obstructive Sleep Apnea:

Apnea which means no breath and Hypopnea which means little breath are potentially life threatening diseases. It is usually due to collapse of pharyngeal structures during sleep. Significant health consequences include Hypertension (high blood pressure), Myocardial Infarction (Heart attack) and stroke. It is a frequent cause of sexual dysfunction, depression and morning headache. It is a major cause of daytime tiredness leading to inattention and increased risk of accident or poor work performance.

Treatment Options:

 Socially
Disruptive
Snoring
Obstructive Sleep Apnea
MildModerate
to Severe
Very Severe
Do Nothing X X    
Nasal Surgery* X X X X
LAUP* X X    
UPPP/Tonsillectomy X X X X
Oral Appliance* X X X X
CPAP*   X X X
Tongue Procedures     X X
MMA*     X X
Tracheostomy        

Other Snoring Procedures

Other surgery might include:

Nasal Surgery - Septoplasty

Nasal septal surgery for deviated nasal septum.

Nasal Surgery - Septoplasty

The nasal septum divides the nasal cavity into two halves. A deviated septum adversely affects breathing through both halves. Correction helps with snoring and sleep apnea as well as daytime breathing. Nasal surgery may include sinus surgery for chronic sinus infection and turbinoplasty for chronic turbinate enlargement.

LAUP (Laser Assisted Uvulopalatoplasty)

LAUP (Laser Assisted Uvulopalatoplasty) is a palate trimming operation. It is effective in patients with elongated soft palates and uvulas. The downside is that post procedure is very painful and usually done under general anesthesia.

UPPP ( Uvulopalatopharyngoplasty)

UPPP ( Uvulopalatopharyngoplasty) and tonsillectomy are the traditional surgical procedures for obstructive sleep apnea. Tonsillectomy is the removal of tonsils and the UPPP is a marked shortening of the soft palate with removal of redundant tissue. It is very painful, but reasonably effective in younger people whose apnea is not very severe. Insurance companies only pay for UPPP in patients who fail CPAP.

 
UPPP Postoperative

Oral appliances

Oral appliances are made by dentists and advance the lower jaw. They are uncomfortable and cause jaw and dental pain. Despite the discomfort, they can be relatively effective.

CPAP (Continuous Positive Airway Pressure)

cpap machine

CPAP (Continuous Positive Airway Pressure) is considered the Gold Standard for treatment of sleep apnea, but regular nightly use of a bulky mask and air pump is socially difficult and has poor compliance.

Tongue procedures and maxillomandibular advancement

Tongue procedures and maxillomandibular advancement are major head and neck procedures usually reserved for patients with skeletal abnormalities or very severe apnea who have failed other approaches.

Tracheostomy bypasses

Tracheostomy bypasses the obstruction of the throat and is only used in the most severe of patients who fail CPAP. It may be also used in patients with other critical medical conditions allowing a safe and secure airway.

tracheostomy tube