Snoring and Sleep Apnea Treatment from Northeast Atlanta ENT
Regarding gender, do you know that problem snoring is more frequent and common in males compared to females? Actually, people who are overweight are more susceptible to problem snoring, and it typically worsens with age.
If you (or your loved one) are a problem snorer, you should not dismiss it as just annoying snoring. Rather, snoring can be an indication of obstructed breathing, which can cause significant complications if not treated.
What Causes Snoring?
If there is an obstruction to the free flow of air throughout the passages at the back of the mouth and nose, you will hear the noisy snoring sounds. Specifically, this is the collapsible area of the airway. It is located where the tongue and upper throat meet the soft palate and uvula.
When these structures come in contact with each other and vibrate while breathing, snoring will occur.
If children snore often, this could potentially be a sign of tonsil and/or adenoid problems. In this case, it is important for the child to get examined by an otolaryngologist. He or she may recommend an adenoidectomy or a tonsillectomy to fix the snoring problem.
Additional causes of snoring:
Poor Muscle Tone in the Tongue and Throat:
If the muscles become too relaxed, the tongue will fall backwards into the airway or the throat muscles in order to draw in from the sides into the airway. It is natural for some relaxation to occur while sleeping. However, it may become a problem if heightened with alcohol or drugs that may cause sleepiness.
Excessive Bulkiness of Throat Tissue:
If children have large tonsils or adenoids, chances are high that they will be snorers. People who are overweight tend to have extra soft tissue in the neck, and this can lead to airway narrowing. It is important to note that tumors or cysts are often rare causes of airway narrowing.
Long Soft Palate and/or Uvula:
A long palate will narrow the opening from the nose into the throat. When someone is practicing relaxed breathing, the excessive soft palate length (and/or uvula) mimics a noisy flutter valve, which causes snoring.
Obstructed Nasal Airways:
When someone’s nose is blocked or stuffed, it requires extra effort to pull the air through the nose. This process creates an exaggerated vacuum in the throat. The vacuum pulls the floppy throat tissues together, and this causes snoring sounds. Therefore, snoring may potentially only occur during hay fever season, or if someone has a cold or a sinus infection.
Furthermore, if someone has a deformity of the nose or nasal septum (deviated septum- “a deformity of the wall that separates one nostril from the other”), this can cause an obstruction (and lead to snoring).
Why is Snoring Serious?
Snoring can be serious for social and medical reasons. Socially speaking, the snorer’s bed partner can become very agitated or ridicule the snorer. Also, snoring can cause many sleepless, restless nights for the bed partner, not to mention fatigue.
Medically speaking, snoring disturbs the natural sleep patterns a person should experience. Therefore, the snorer never has adequate rest. Also, snoring can be a sign of obstructive sleep apnea (OSA). OSA, if left untreated, can lead to dangerous, long-term health complications.
What is Obstructive Sleep Apnea?
- Multiple episodes of breathing pauses which are greater than 10 seconds at a time— this is OSA.
- OSA is due to upper airway narrowing or collapse.
- Once the airway narrows or collapses, lower amounts of oxygen enter the blood. This, in turn, causes the heart to work harder.
- OSA causes a person to experience disrupted sleep patterns, not the natural sleep cycle. Inadequate sleep makes people feel poorly rested, even though he or she spent a lot of time in bed.
- Sleep apnea sufferers may experience such episodes approximately 30-300 events per night. OSA sufferers must sleep lightly, while keeping the throat muscles tense, so that the airflow can continue through to the lungs.
- Poor rest can lead to impaired job performance, and also lead to dangerous and hazardous situations for a sleep apnea sufferer to drive or operate equipment.
- If left untreated, obstructive sleep apnea sufferers are at higher risk of strokes, heart attacks, diabetes, and other medical issues.
How do You Evaluate Heavy Snoring?
If you or a loved one snores heavily, it is best to seek medical help right away.
How do you determine if you snore heavily? Answer: if you snore constantly when laying down in any position; or if your snoring negatively impacts your bed partner’s sleep.
If you find yourself in this situation, seek help from an otolaryngologist. He or she will conduct a thorough examination of the throat, palate, nose, mouth, and neck. A fiberoptic scope will be used to complete this examination. This exam can determine the underlying causes of snoring— a nasal allergy, nasal obstruction, infection, and/or enlargement of adenoids and tonsils.
In addition, a sleep study may be necessary to determine if OSA is the cause of the snoring. The sleep study can be conducted in your home or in a laboratory.
- daytime sleepiness
- daytime fatigue
- heart disease
- high blood pressure
- history of a stroke
- witnessed episodes of breath pauses or apnea while sleeping
Treatment Options for Obstructive Sleep Apnea
Treatment for heavy snorers will depend on the diagnosis and the level(s) of upper airway narrowing. For some patients, more than one area can be involved.
There are a few different ways to treat OSA or snoring, and sometimes, various treatments are recommended by an otolaryngologist head and neck surgeon.
Continuous Positive Airway Pressure—CPAP
One treatment option for obstructive sleep apnea sufferers is a CPAP machine. Many patients respond very well to this treatment. The CPAP device will open the person’s airway with a small amount of positive pressure while sleeping. He or she will wear a nasal mask while sleeping. The CPAP is typically the first choice of treatment for patients.
Uvulopalatopharyngoplasty is surgery performed in order to treat snoring and OSA. The procedure will remove excess soft palate tissue. This will open up the airway. Additionally, the remaining tissue will stiffen up as it heals, which will minimize tissue vibration (thus decreasing or eliminating snoring). If the air passageway needs to be opened up even more, a tonsillectomy can be performed at the same time of a Uvulopalatopharyngoplasty surgery.
Thermal Ablation Procedures
This type of procedure will recede the tissue bulk in the nasal turbinates, soft palate, and/or the tongue base. Thermal ablation procedures can be used to treat OSA and snoring problems.
Different types of thermal ablation procedures include: laser, bipolar cautery, and radio frequency. The procedures are usually completed in the operating room or during a doctor office visit. There is a chance that a few treatments will be required.
Soft Palate Treatment Methods
There are a couple of methods that will increase the stiffness of the soft palate, but will not remove the tissue. One method is to inject a substance that will cause stiffness in the injected area near the uvula. The second method is the insertion of stiffening rods, called Pillar implants, into the soft palate.
Genioglossus and hyoid advancement
Genioglossus and hyoid advancement is a type of surgery to treat sleep apnea. The surgery will prevent the collapse of the lower throat, and it will pull the tongue muscles forward. The result is an opened, unobstructed airway.
A Custom-fitted Oral Appliance
Like the CPAP option, the custom-fitted oral appliance is a great treatment method for those who do not want surgery. The oral appliance will reposition the lower jaw forward. An otolaryngologist who has expertise in sleep dentistry can create a custom-fitted oral mouthpiece for you.
For some patients who lost a significant amount of weight, their OSA and snoring problems improved. One more reason to lose weight!
What Should You Do Now?
Do you need to get evaluated for your snoring problems? Do you need to rule out potential OSA and/or receive proper treatment for sleep apnea? Just call Northeast Atlanta ENT at either of our offices (Lawrenceville or Johns Creek, GA.) to schedule an appointment.