Snoring and Sleep Apnea

Snoring is the hoarse or harsh sound that occurs when your breathing is partially obstructed in some way while you’re sleeping. Sometimes snoring may indicate a serious health condition. In addition, snoring can be a nuisance to your partner.

As many as half of adults snore sometimes. Snoring occurs when air flows past relaxed tissues in your throat, causing the tissues to vibrate as you breathe, which creates those irritating sounds.

Lifestyle changes, such as losing weight, avoiding alcohol close to bedtime or sleeping on your side, can help stop snoring.

In addition, medical devices and surgery are available that may reduce disruptive snoring. However, these aren’t suitable or necessary for everyone who snores.

To treat your condition, your doctor likely will first recommend lifestyle changes, such as losing weight, avoiding alcohol close to bedtime and changing sleeping positions. If lifestyle changes don’t eliminate snoring, your doctor may suggest:

  • Oral appliances.Oral appliances are form-fitting dental mouthpieces that help advance the position of your tongue and soft palate to keep your air passage open.

If you choose to use an oral appliance, visit your dental specialist at least once every six months during the first year, and then at least annually after that, to have the fit checked and to make sure that your condition isn’t worsening. Excessive salivation, dry mouth, jaw pain and facial discomfort are possible side effects from wearing these devices.

  • Continuous positive airway pressure (CPAP).This approach involves wearing a pressurized mask over your nose while you sleep. The mask is attached to a small pump that forces air through your airway, which keeps it open. CPAP (SEE-pap) eliminates snoring and treats sleep apnea.

Although CPAP is the most reliable method of treating obstructive sleep apnea, and it’s effective, some people find it uncomfortable or have trouble adjusting to the noise or feel of the machine. Your doctor may be able to make adjustments to the device if you’re having trouble adjusting to the machine, such as adding a heated humidifier or nasal pillows, that might help make you more comfortable.

  • Palatal implants.In this procedure, known as the pillar procedure, doctors inject braided strands of polyester filament into your soft palate, which stiffens it and reduces snoring. Palatal implants don’t have any known serious side effects; however, the benefits and safety of the procedure are still being studied.
  • Traditional surgery.In a procedure called uvulopalatopharyngoplasty (UPPP), you’re given general anesthetics and your surgeon tightens and trims excess tissues from your throat — a type of face-lift for your throat. The risks of this procedure include bleeding, infection, pain and nasal congestion.
  • Laser surgery.In laser-assisted uvulopalatopharyngoplasty (LAUPPP), an outpatient surgery for snoring, your doctor uses a small hand-held laser beam to shorten the soft palate and remove your uvula. Removing excess tissue enlarges your airway and reduces vibration. You may need more than one session to get your snoring under control.

uyku_1Laser surgery and palatal implants aren’t generally recommended as treatment for sleep apnea, because they haven’t been proved effective for sleep apnea. Possible risks from these procedures include pain, infection, bleeding and nasal congestion.

  • Radiofrequency tissue ablation (somnoplasty).In this outpatient procedure, you’ll be given local anesthetic. Doctors use a low-intensity radiofrequency signal to shrink tissue in the soft palate to help reduce snoring. The effectiveness of this newer procedure needs further study. Generally, this procedure is less painful than other types of snoring surgery.

Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. You may have sleep apnea if you snore loudly and you feel tired even after a full night’s sleep.

There are two main types of sleep apnea:

  • Obstructive sleep apnea,the more common form that occurs when throat muscles relax
  • Central sleep apnea,which occurs when your brain doesn’t send proper signals to the muscles that control breathing

If you think you might have sleep apnea, see your doctor. Treatment is necessary to avoid heart problems and other complications.

Your doctor may make an evaluation based on your signs and symptoms or may refer you to a sleep disorder center. There, a sleep specialist can help you decide on your need for further evaluation. Such an evaluation often involves overnight monitoring of your breathing and other body functions during sleep. Home sleep testing is gaining in popularity, because it’s often easier for you and less expensive. Tests to detect sleep apnea may include:

  • Nocturnal polysomnography.During this test, you’re hooked up to equipment that monitors your heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while you sleep.
  • Home sleep tests.In some cases, your doctor may provide you with simplified tests to be used at home to diagnose sleep apnea. These tests usually involve measuring your heart rate, blood oxygen level, airflow and breathing patterns. If you have sleep apnea, the test results will show drops in your oxygen level during apneas and subsequent rises with awakenings. If the results are abnormal, your doctor may be able to prescribe a therapy without further testing. Portable monitoring devices don’t detect all cases of sleep apnea, so your doctor may still recommend polysomnography even if your initial results are normal.

If you have obstructive sleep apnea, your doctor may refer you to an ear, nose and throat doctor (otolaryngologist) to rule out any blockage in your nose or throat. An evaluation by a heart doctor (cardiologist) or a doctor who specializes in the nervous system (neurologist) may be necessary to look for causes of central sleep apnea.