One third of middle aged and older adults are habitual snorers. It is more frequent in males and overweight people and usually worsens with age. The sounds of snoring occur when there is an obstruction to the free flow of air through the passages at the back of the mouth and nose. Snoring occurs when structures in these narrow areas strike each other and vibrate during breathing.
A relaxed and thick soft palate, an elongated uvula, large tonsils, adenoids and tongue base may result in narrowing of the throat. Overweight people usuallly have excess soft tissue in the neck that can also lead to airway narrowing. Alcohol intake prior to sleep may cause further relaxation of muscles which may cause snoring. Obstructed nasal airways resulting from chronic sinusitis, deviated septum, hypertrophied turbinates are also common disorders related with snoring.
Snoring may be a sign of a more serious condition known as obstructive sleep apnea. It is characterized by multiple episodes of breathing pauses greater than 10 seconds at a time, due to upper airway narrowing or collapse. This results in lower amounts of oxygen in the blood, which causes disruption of the natural sleep cycle making one feel poorly rested despite adequate time in bed.
When to seek medical attention?
The snorer may not be aware of the consequences but, the bed partner may experience sleepless nights and fatigue. Snoring disturbs sleeping patterns and deprives the snorer of adequate rest. It may be a sign of obstructive sleep apnea (OSA), which can lead to serious, long-term health problems.
Children usually snore due to enlarged adenoids and/or tonsils. If your child snores regularly and sleeps in discomfort, you should seek medical advice from an otolaryngologist.
Evaluation and Diagnosis
The degree of sound generated during snoring may be an indication to have a medical examination. Snoring greater than 1st degree requires treatment:
1st degree: Snoring can be heard when the ear is close to the snorer’s face
2nd degree: Snoring can be easily heard within the bedroom
3rd degree: Snoring can be heard close the bedroom when the door is open
4th degree: Snoring can be heard outside the bedroom when the door is closed
Evaluation of snoring should start with a physical examination. An otolaryngologist will provide a thorough examination of the nose, mouth, throat, palate, and neck, often using a fiberoptic scope. A sleep study in a laboratory or at home may be necessary to determine if snoring is due to OSA.
Related problems (when OSA is present)
- Daytime sleepiness or fatigue
- High blood pressure
- Heart disease
- Stroke
- Diabetes
- Attention deficit disorder in children
Self-treatment
- Lose weight if you are overweighed.
- Sleep on your side rather than your back.
- Avoid alcohol for at least four hours before bedtime.
- Avoid tranquilizers, sleeping pills, and antihistamines before bedtime.
- Avoid heavy meals or snacks for three hours before retiring.
- Adopt a healthy and athletic lifestyle to develop good muscle tone
- Establish regular sleeping patterns.
Medical management
Your physician may recommend the following treatment options, tailored for the needs of every individual. Treatment depends on the diagnosis and level(s) of upper airway narrowing and in some cases, more than one area may be involved.
- Surgery of the soft palate and uvula: There are several surgical procedures for removal of excessive tissues obstructing the airway or remodelling these structures Such procedures may be performed using cold knife, electrocautery, radiofrequency or, lasers. CLICK HERE to watch a video demonstrating an effective procedure called “anterior palatoplasty”, which increases tension of the soft palate to reduce vibrations and snoring sound.
- Radofrequency surgery: Radiofrequency energy is commonly applied under local anesthesia to the soft palate. It results in stiffening of the vibrating palate within 6 weeks. Repeated procedures may be necessary, 2 or 3 times, 2 monts apart.
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| Technique of radiofrequency surgery of the soft palate | Sites of radofrequency ablation of the soft palate |
