Snoring and Obstructive Sleep Apnea

Go to: Obstructive Sleep Apnea

Snoring

45 percent of normal adults snore at least occasionally and 25 percent are habitual snorers. Snoring is noisy breathing occurring when there is an obstruction to airflow through the passages at the back of the nose and mouth during inhalation. Snoring results when upper airway structures come in contact with each other and vibrate during breathing.

Snoring may be caused by:

  • Decreased muscle tone in the tongue and throat: When muscles are too relaxed, the tongue falls backwards into the airway or the throat muscles draw in from the sides into the airway. Conditions that cause decreased muscle tone include alcohol, sedative medications and extreme fatigue.
  • Excessive bulkiness of throat tissue: Children with large tonsils and adenoids often snore. People who are overweight may have excess soft tissue surrounding and narrowing the throat. Throat or neck tumors can also cause airway narrowing.
  • Long soft palate and/or uvula: A long palate narrows the opening from the nose into the throat.
  • Nasal obstruction: Snoring may occur due to nasal congestion from a cold or allergies. Other conditions such as deviated nasal septum can also cause snoring.

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Obstructive Sleep Apnea

Snoring may be a sign of a more serious condition known as obstructive sleep apnea (OSA). Obstructive sleep apnea occurs when collapse of upper airway tissues during sleep causes a temporary but complete cessation of airflow lasting 10 seconds or more. This results in lower amounts of oxygen in the blood, causing the heart to work harder. When the oxygen level drops, the body responds by waking the patient up enough to open the throat and gasp for air. Apnea patients may experience 30 to 300 such events per night. As the result, their sleep cycle is disrupted and patients feel poorly rested despite spending adequate time in bed. Over time, if left untreated, obstructive sleep apnea increases the risk of developing hyprtension, heart attacks, strokes, diabetes and other medical problems.

Snoring associated with witnessed episodes of breath pauses or daytime fatigue should be evaluated for possible obstructive sleep apnea. The breathing passages of the nose and throat should be carefully evaluated for possible structural causes of snoring and apnea. Nasopharyngoscopy is usually performed (examination of the nasal cavity and throat with a fiberoptic telescope) and most heavy snorers are referred for a polysomnogram (sleep study).

Medical and surgical treatments exist for snoring and obstructive sleep apnea.

Medical treatment options include:

  • Weight loss
  • Alcohol and sedative avoidance
  • Sleep position training
  • Continuous Airway Positive Pressure (CPAP) machines
  • A custom-fit oral appliance worn during the night

Surgical treatment options include:

  • Nasal surgery – straightning of the obstructing nasal septum, reduction of inferior turbinate‚Äôs, nasal valve surgery
  • Palate procedures – stiffening of the soft palate using radiofrequency or pillar implants
  • Uvulopalatopharyngoplasty (UPPP) – trimming the palate and tightening the sidewalls of the throat. This procedure may be combined with tonsillectomy.
  • Genioglossus advancement – advancing a portion of the jaw and tongue forward
  • Hyoid suspension – tightening the walls of the throat
  • Maxillomandibular advancement – moving the upper and lower jaw forward

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