Snoring is a very common problem. At least 45% of adults snore occasionally and 25% snore every night. It is more common in males and persons who are overweight. Snoring also tends to worsen with age.
Most people are unaware that they snore; it is often brought to their attention by a sleepless bed partner. Many couples have been sleeping separately for years so that at least one of them can get a full night’s sleep. Besides loneliness, a poor night’s sleep can lead to decreased job performance and hazardous driving.
Snoring can also be a sign of more serious problems. When loud snoring becomes associated with frequent episodes of totally obstructed breathing, then the snorer may be experiencing obstructive sleep apnea (OSA). If left untreated, this condition may lead to high blood pressure, heart and lung disease, and stroke. An overnight sleep study, performed either at home or in a sleep laboratory, is usually required to make a diagnosis of OSA.
Snoring can be caused by obstruction in the nose, mouth or both. The loud and irritating noise associated with snoring occurs when there is an obstruction to the free flow of air in the nose or in the collapsible part of the airway where the tongue and upper throat meet the soft palate and uvula. As these structures contact each other and vibrate when taking a breath, the snoring sound is created.
The key to improving snoring is to lessen the impact that nasal or oral obstruction has on the free flow of air through the nose and/or mouth while sleeping. This can be achieved through medical or surgical intervention. Sustained weight loss and avoidance of sedatives can often markedly improve snoring.
Most snorers can benefit greatly from a variety of office-based or same-day surgical procedures which can be tailored to the source and degree of airway obstruction. It is important to correct any significant nasal component of snoring first as this is the natural form of breathing. Nasal obstruction due to enlarged turbinates (finger-like projections which hang off the sidewall of the nasal cavity) can be improved by performing a short outpatient procedure to reduce the bulkiness of tissue with little or no post-operative discomfort. If the nasal septum (the wall which separates the right and left nasal cavity) is blocking the airway, then a septoplasty can be performed as well on a same-day surgery basis. Sinus surgery, if required, could also be performed at this time.
Once the nasal component of snoring, if any, is addressed, then the oral obstruction can be improved. This is often addressed by procedures performed in our office.
Some patients, particularly those with very thickened soft palates or very long uvulas, may benefit from a Cautery-Assisted Palatal Stiffening Operation (CAPSO). This technique uses electrocautery to remove a midline, arch-shaped portion of soft palate mucosa and the uvula. Scar forms which stiffens the soft palate. Thus, palatal snoring significantly improves or resolves. This procedure is brief and performed in our office as well. Dr. Bosworth had the opportunity to train with the physicians who developed this technique as well and is one of the only surgeons performing this technique in this area.
Snoring can last a lifetime but doesn’t have to. A variety of mostly office-based procedures are available to improve a snorer’s lifestyle, both by day and night.