Sleep
Snoring is caused by vibration of collapsed throat tissue. A common site is the soft palate around the tonsils. 50% of all men and about 1/3 of all female adult Americans snore. There is even some evidence that snoring alone may negatively impact health. Snoring can be a sign of obstructive sleep apnea (OSA) affecting approximately 20 million Americans. The number of undiagnosed OSA patients is likely much higher. In OSA the throat tissue collapses while sleeping, which, in very severe cases, may occur once every minute resulting in repeated sleep interruptions.
Many but not all patients with OSA may suffer from any of the following symptoms:
- Snoring
- Nocturnal choking and gasping for air
- Fatigue/ frequent napping
- (Morning) headaches
- Memory loss
- Anxiety and depression
Early recognition and treatment of sleep apnea are important because it can lead to severe complications:
- High blood pressure
- Heart attacks
- Irregular heartbeats (arrhythmia)
- Stroke
- Depression
- Increased risk of car accidents
- Increased risk of early death (up to 15 years sooner)
Surgical Treatment for
Snoring
Snoring is caused by throat tissue vibration. Opening the nasal passage or correcting a deviated septum, and removing excessive tissue such as adenoids or tonsils can often help improve snoring. In some cases, shortening (palatoplasty) or stiffening (radiofrequency therapy) of the soft palate must be considered to improve snoring.
NON-SURGICAL TREATMENT FOR OSA
CPAP and BiPAP
This is the most common treatment for OSA and consists of either continuous or bi-level positive pressure (CPAP/ BiPAP), which is delivered via face or nasal mask to stent the upper airway passage open while asleep. If used as instructed, this therapy is very effective. Some patients have trouble using this therapy due to mask-related discomfort.
Oral Appliance
For patients with mild or moderate OSA, an oral appliance can be an effective therapy option. This custom-made appliance stabilizes the lower jaw in a more forward position, which moves the tongue and the attached soft tissue out of the way so that patients can breathe better at night.
Adjunct Therapy
Other treatment alternatives in the management of OSA include weight loss, positional therapy with special pillows and body positional devices, which can sometimes lead to significant improvement of OSA. Other lifestyle changes that should be implemented include smoking cessation, alcohol avoidance, and sleep hygiene. Correction of nasal obstruction (e.g., decongesting sprays, breath-rite strips, nasal surgery) can sometimes help with CPAP compliance.
SURGICAL TREATMENT FOR OSASLEEP APNEA ANORING
Over 50% of patients are not able to tolerate or adhere to CPAP and are at risk to develop other medical conditions. The success of sleep surgery largely depends on the correct identification of anatomical structures responsible for OSA. In some cases, more than one area of collapse can be found, which may include soft palate, tonsils, or base of tongue.
Patients who cannot tolerate CPAP should not give up. There are many other options available and it is crucial to consult with an experienced upper airway surgeon, such as Dr. Weidenbecher, who will develop a tailored treatment plan for patients. The end goal is always significant improvement of the OSA with patients experiencing restful sleep. In some cases, this means that more than one surgery might be needed to get there, or surgery might be combined with some other non-surgical treatment modalities.
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