Snoring & Sleep Apnea

Snoring/Obstructive Sleep Apnea

Forty-five percent of normal adults snore at least occasionally, and 25 percent are habitual snorers. Problem snoring is more frequent in males and overweight persons, and it usually grows worse with age.

What Causes Snoring?

The noisy sounds of snoring occur when there is an obstruction to the free flow of air through the passages at the back of the mouth and nose. This area is the collapsible part of the airway where the tongue and upper throat meet the soft palate and uvula. Snoring occurs when these structures strike each other and vibrate during breathing.

People who snore may suffer from:

  • Poor muscle tone in the tongue and throat. When muscles are too relaxed, either from alcohol or drugs that cause sleepiness, the tongue falls backwards into the airway or the throat muscles draw in from the sides into the airway. This can also happen during deep sleep.
  • Excessive bulkiness of throat tissue. Children with large tonsils and adenoids often snore. Overweight people have bulky neck tissue, too. Cysts or tumors can also cause bulk, but they are rare.
  • Long soft palate and/or uvula. A long palate narrows the opening from the nose into the throat. As it dangles, it acts as a noisy flutter valve during relaxed breathing. A long uvula makes matters even worse.
  • Obstructed nasal airways. A stuffy or blocked nose requires extra effort to pull air through it. This creates an exaggerated vacuum in the throat, and pulls together the floppy tissues of the throat, and snoring results. So, snoring often occurs only during the hay fever season or with a cold or sinus infection.

Also, deformities of the nose or nasal septum, such as a deviated septum (a deformity of the wall that separates one nostril from the other) can cause such an obstruction.

Snoring can be a symptom of a more serious problem known as obstructive sleep apnea. In this disease, the airway becomes totally blocked leading to daytime fatigue, elevated blood pressure and increased risk of heart attack and stroke. Sleep apnea is diagnosed by symptoms, physical exam and sleep study, and treatment may be medical or surgical.

Snoring Treatment

Treatment depends on the diagnosis. An examination will reveal if the snoring is caused by nasal allergy, infection, deformity, or enlarged tonsils and adenoids.

Treatment depends on the diagnosis. An examination will reveal if the snoring is caused by nasal allergy, infection, deformity, or enlarged tonsils and adenoids.

Snoring or obstructive sleep apnea may respond to various treatments now offered by many otolaryngologist-head and neck surgeons:

  • Uvulopalatopharyngoplasty (UPPP) is surgery for treating obstructive sleep apnea. It tightens flabby tissues in the throat and palate, and expands air passages. It includes tonsil removal.
  • Thermal Ablation Palatoplasty (TAP) refers to procedures and techniques that treat snoring. Some of them also are used to treat various severities of obstructive sleep apnea. Different types of TAP include bipolar cautery, laser and radiofrequency. Laser Assisted Uvula Palatoplasty (LAUP) treats snoring and mild obstructive sleep apnea by removing the obstruction in the airway. A laser is used to vaporize the uvula and a specified portion of the palate in a series of small procedures in a doctor's office under local anesthesia. Radiofrequency ablation, or Coblation™, utilizes a needle electrode to emit energy to shrink excess tissue to the upper airway including the palate and uvula (for snoring), base of the tongue (for obstructive sleep apnea), and nasal turbinates (for chronic nasal obstruction). This procedure is approved by the FDA.
  • Genioglossus and hyoid advancement is a surgical procedure for the treatment of sleep apnea. It prevents collapse of the lower throat and pulls the tongue muscles forward, thereby opening the obstructed airway.

All surgeries for sleep apnea are performed in the hospital with an overnight stay. Plan on one week out of work.

If surgery is too risky or unwanted, the patient may sleep every night with a nasal mask that delivers air pressure into the throat; this is called continuous positive airway pressure or CPAP.

A chronically snoring child should be examined for problems with his or her tonsils and adenoids. A tonsillectomy and adenoidectomy may be required to return the child to full health.

For more information about snoring and sleep apnea, Dr. Michael Pickford or Gwinnett ENT, please call us at 678-312-7390.