SNORING AND SLEEP APNEA EVALUATION AND TREATMENT

 

ABOUT

-          Snoring represents a partial blockage in the normal flow of air when you breathe, causing noisy breathing.  This blockage may occur at one place or several places and may change over time. 

-         If a blockage becomes complete, you stop breathing, which is called apnea.  You can notice apnea when snoring becomes louder and louder until is stops.  Your brain senses that there is no oxygen and wakes you up, as you take a gasp, and the cycle starts over.

-         People with these problems can have snoring so loud that it can be heard outside the room. 

-         Signs of sleep apnea can include: excessive daytime sleepiness, awakening in the middle of the night, loud gasps or choking while sleeping, morning headaches, dry mouth, sore throat, sexual dysfunction, depression, memory difficulties, irritability and impaired daytime functioning (which can lead to car accidents or sleeping at work). 

-         In addition to these lifestyle problems, sleep apnea increases the risk of high blood pressure, heart attack, arrythmias (irregular heartbeats) and stroke.

-         Snoring and sleep apnea are evaluated with a sleep study which can be performed in a Sleep Center or in your home.

 

SOLUTIONS

-          There is a wide range of treatments for snoring and sleep apnea, depending on the location and severity of the problem(s). 

-         These measures are discussed briefly below but your BCENTS doctor will discuss them in depth with you after an exam and complete evaluation. 

 

1.  MEDICATIONS AND ALCOHOL.  Avoid any medications or beverages which will relax your tissues and increase collapse.  Avoid alcohol, sedatives, tranquilizers, sleeping pills and narcotics.  Smoking has also been show to worsen sleep apnea.

 

2.  ADEQUATE SLEEP.  Do not deprive yourself of adequate sleep because of your schedule.  Sleep deprivation has been shown to worsen sleep apnea.

 

3.  DIET AND EXERCISE.  If you are overweight, the excess weight leads to worsening collapse.  Weight loss will reduce the amount of tissues causing collapse and improve sleep apnea.

 

4.  SLEEPING POSITIONS.  Sleeping on your back greatly increases snoring as compared to sleeping on your side or stomach.  To help you from turning over while asleep, you can sleep wearing a t-shirt with a tennis ball sewn to the back, so it is uncomfortable to turn on your back.  There is also t-shirts available with the tennis ball attached.  See: http://tennisballtshirt.com or http://yoursnorestore.com/.

 

5.  NOSE.   If you have any problems breathing through your nose, correcting those problems will improve snoring and apnea.  Allergies can be treated with avoidance measures, antihistamines or shots.  Breathe-Right Strips or surgery can improve structural blockage or collapse.  A humidifier can also be useful to help your mouth and throat from drying out while sleeping.  Nasal steroid sprays can also help open the nose on a daily basis without the risk of addiction (as seen with decongestant nose sprays).

 

6.  DEVICE.  Several devices can be worn during sleep to decrease blockage. 

-  CPAP is a mask which blows air under pressure into your nose and/or mouth while you sleep. 

-  Mandibular advancement prostheses are worn like a dental retainer to force your jaw and tongue forward while you sleep.  These often help but have a risk of jaw pain, occlusal changes and TMJ problems and cost $ 1000-1500.

 

7.  SURGERIES.    Surgical procedures target the specific anatomical area of blockage.

-  Septoplasty straightens a crooked septum inside the nose.

-  Tonsillectomy and/or adenoidectomy remove large tonsils/adenoids which can increase the space to breathe.

-  UPPP (Uvulo-palato-pharyngoplasty) removes excess palate tissues including the uvula.

-  Injection Snoreplasty stiffens the palate to reduce snoring from palatal flutter.

-  Inspire Hypoglossal Nerve Stimulation is a implant procedure which stimulates the nerve to the tongue, increasing its tone while the patient sleeps and opening the airway for patients with an AHI=20-65 who are not significantly overweight and cannot tolerate CPAP.

 

QUESTIONS

Do you snore?      

Are you unable to stay awake in the daytime? 

Do you wake up in the middle of the night unable to breathe or gasping for air?

Do you have a hard time staying asleep?                  

Has someone seen or heard you stop breathing while asleep?                

Do you wake up with a headache during the night or in the morning?    

Do you wake up with choking and gasping?            

Do you have trouble staying asleep once you fall asleep?                       

Do you doze off or fall asleep during the day while Sitting and reading, Watching TV, As a passenger in a car, or in a car while stopped for a few minutes in traffic            

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