Snoring
Snoring is loud, noisy breathing during sleep that is caused by the vibration of tissue in the nose or throat. Snoring may be very embarrassing to an individual and frustrating to a person’s bedmate as well.
It has been estimated that 30% to 50% of the U.S. population snore at some time or another. Significant snoring is sometimes described as "heroic" snoring, when the sound can be heard more than two bedrooms away.
Such snoring may cause several problems, including:
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Marital discord and relationship problems
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Sleep disturbances (from spousal prodding)
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Waking episodes (from one's own snoring)
Snoring is not sleep apnea, and sleep apnea is not snoring. Snoring is a social problem. However, many patients who snore loudly do have significant obstructive sleep apnea.
Causes
Soft palate
The soft palate is located in the back of the mouth. Over time, the tissue and muscles of the soft plate may lose stiffness and begin to sag. As an individual breathes in, this sagging tissue vibrates, causing snoring.
Uvula
The uvula extends from the soft palate and looks like a hanging U. An elongated or thick uvula also may vibrate with breathing, contributing to snoring at night.
Nasal turbinates
These are small bones within the nose. When they become enlarged, they may vibrate and lead to snoring.
Large tongue
A large tongue may vibrate, causing snoring.
Adenoids
Adenoid tissue, or tonsillar tissue in the back of the nose, may cause nasal obstruction and lead to snoring.
Treatment
Primary snoring treatment can include nonsurgical or surgical approaches. Nonsurgical treatment methods include weight loss and sleeping position changes (keeping the snorer off his/her back).
Other treatments include radiofrequency procedures:
- Somnoplasty
- Palatal implants
- Injection snoreplasty
- Mandibular advancement device (MAD)
- Cautery assisted palatal stiffening operation (CAPSO)
Somnoplasty and coblation are radiofrequency treatments aimed at mild-to-severe snorers (who do not have sleep apnea). This technology uses radiofrequency techniques to stiffen the palate.
Nasal turbinate reduction
Nasal turbinates may be enlarged, contributing to snoring. The size of the nasal turbinates may be reduced using procedure in which radiofrequency energy is directed at the turbinate tissue, reducing the size of the tissue over time and increasing the size of the airway.
This procedure may be performed in an office using local anesthesia or in an operating room under general anesthesia.
Uvulectomy
An enlarged uvula may lead to snoring, as well as problems with throat irritation and even difficulty swallowing. Uvulectomy is a procedure in which the uvula is removed, decreasing the chance of snoring.
A uvulectomy may be performed in an office using local anesthesia or under general anesthesia in an operating room.
Radiofrequency treatment
If a large soft palate is causing snoring, radiofrequency treatment may be needed. This treatment involves placing a small probe that delivers energy to the palate. With time, the tissue shrinks and develops a scar, reducing the snoring.
Radiofrequency palate treatment may be performed in an office using only local anesthesia. It is usually performed over multiple visits to enhance results.
Laser-assisted uvulopalatolasty
Laser-assisted uvulopalatolasty is used to treat snoring (and sleep apnea) by removing the uvula and reducing the size of the palate tissue. This increases the size of the airway, decreasing the chance of snoring.
This procedure may be performed in an office or an operating room.
Pillar procedure
The pillar procedure is performed for patients with a large and redundant soft palate. This procedure is usually performed in the office with only local anesthesia.
Small implants are placed into the soft palate that stiffen the palate over time. As the palate stiffens around the implants, the palate shrinks, opening the airway and decreasing the chance of snoring.
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