Approximately 50% of healthy adults snore occasionally, and at least 25% are habitual snorers. Factors that increase the risk of snoring are being overweight, increased age, and being male. 10% of children snore regularly, which can disrupt normal sleep and affect growth, behavior, and learning. Snoring generally indicates obstructive breathing and should not be overlooked, as it can be a sign of something more serious like obstructive sleep apnea. In addition, snoring can cause the bed partner to experience sleep disturbance and fatigue.
Obstructive Sleep Apnea (OSA)
Obstructive Sleep Apnea is the result of multiple pauses in breathing, greater than 10 seconds at a time, from narrowing or collapse of the upper airway. This results in interruptions in the various stages of sleep causing poor sleep quality which can cause daytime fatigue. In addition, this can lead to other medical problems such high blood pressure, heart attacks, strokes, diabetes, dementia, and certain lung problems.
What Are the Symptoms of OSA?
Symptoms associated with OSA can include:
- Loud snoring
- Pauses in breathing during sleep
- Waking up gasping or choking
- Waking up with a dry mouth or sore throat
- Daytime sleepiness or fatigue
- Frequent nighttime urination
- Morning headache
- Irritability, mood changes, depression, difficulty concentrating
- High blood pressure, heart disease, stroke, or other cardiac issues
What are the causes of Snoring and Sleep Apnea?
Obstruction to the free flow of air throughout the passages at the back of the mouth and nose cause snoring. The vibration of the collapsible part of the airway, where the tongue and upper throat meet the soft palate and uvula, causes the noisy sounds of snoring. In children, enlarged tonsils and adenoids are the most common cause of snoring. Obstruction of the nasal airways can also require extra effort to move air through the upper airway, pulling together the floppy tissues of the throat.
How is Snoring and Sleep Apnea Evaluated?
An otolaryngologist evaluates for different causes of snoring by performing examination of the upper airway including the nose, mouth, throat, palate, and neck; and sometimes uses a fiberoptic scope to examine deeper in your throat.
A sleep study (polysomnography) is required to diagnose sleep apnea. In adults, this is most often performed from the comfort of your own home. In younger children this is performed in a sleep lab. Sleep studies measure oxygen, breathing, and air movement. We offer SNAP home sleep studies. We can provide you with the equipment to perform a sleep study in the comfort of your own home and then make treatment recommendations based on sleep study findings.
What are the Treatments for Snoring and Sleep apnea?
Treatment depends on the severity of the snoring, if sleep apnea is present, and the anatomic reason that the upper airway is narrow. Sometimes, more than one area is involved, requiring multiple different treatments.
Sleep apnea is most often treated with continuous positive airway pressure (CPAP). This is a device worn during sleep that delivers a small amount of pressure to keep the airway open.
Alternatives include, a custom-fit oral appliance may, weight loss, and surgery.
Oral Appliances for sleep apnea are no bigger than orthodontic retainers, yet can treat snoring and sleep apnea by opening the airway behind your tongue. These are custom made for you by a dentist with a special focus on sleep apnea. We can help you decide if this is the right option for you.
There are numerous surgical treatments for snoring/OSA, including:
- Uvulopalatopharyngoplasty (UPPP)-- removal of excess soft tissue in the palate and throat, to open the airway.
- Nasal surgeries to reduce tissue bulk in the nose.
- Radiofrequency ablation of the tongue to shrink the back of the tongue and prevent it from collapsing.
- The soft palate may be stiffened by inserting stiffening rods into the soft palate.
- “Hypoglossal nerve stimulator” technology implants a tongue pacemaker, which stiffens and projects the tongue forward during sleep. Other procedures may be used to surgically target tongue muscles or the boney configuration of the midface.