Snoring and Sleep Apnea

Loud snoring can be a sign of obstructive sleep apnea (OSA), a life threatening disorder.

Sleep disturbances and waking up episodes doesn’t necessarily mean the person has OSA, that’s why it’s important to distinguish snoring and OSA. Some non-medical treatments that can help chronic snoring include:

Weight loss — as little as 10 pounds may be enough to make a difference.

Change of sleeping position — Because you tend to snore more when sleeping on your back, sleeping on your side may be helpful.

Avoid alcohol, caffeine and heavy meals — especially within two hours of bedtime.

Avoid sedatives Sedatives increase the tendency for airway obstruction.

Radio Frequency (RF) Radio waves can be used to shrink the tissue in the throat or tongue, while outer tissue remains unharmed. Long-term success of this procedure has not yet been determined.

Laser-Assisted Uvuloplasty (LAUP) is a surgical procedure that removes the uvula and surrounding tissue to open the airway behind the palate. This procedure is generally used to relieve snoring and can be performed in the Oral and Maxillofacial Surgeon’s office with local or general anesthesia.

Undiagnosed OSA risks heart attack, stroke, irregular heartbeat, high blood pressure, heart disease and decreased libido and can be life-threatening. The symptoms may be mild, moderate or severe and can cause daytime dizziness.

For those with sleep apnea, the upper airway can be obstructed by excess tissue, large tonsils or a large tongue, which alerts the body to wake the brain to restart the breathing process. This occurence repeats itself many times during the night and causes sleep deprivation and health-related issues.

Other symptoms may include:

  • Snoring with pauses in breathing (apnea)
  • Excessive daytime drowsiness
  • Gasping or choking during sleep
  • Restless sleep
  • Problem with mental function
  • Poor judgment/can’t focus
  • Memory loss
  • Quick to anger
  • High blood pressure
  • Nighttime chest pain
  • Depression
  • Problem with excess weight
  • Large neck (>17″ around in men, >16″ around in women)
  • Airway crowding
  • Morning headaches
  • Reduced libido
  • Frequent trips to the bathroom at night
If you notice any OSA symptoms, schedule an appointment with your oral & maxillofacial surgeon for a complete examination and diagnosis.

Your doctor will look for problems that might contribute to sleep-related breathing problems and interview household members about your sleeping and waking behavior. If the diagnosis is a sleep disorder, you may be referred to a sleep clinic to monitor your sleep patterns.

Your doctor will choose the right treatment for you, based on whether your OSA is mild, moderate or severe.

Behavior Modification - Your doctor may recommend non-medical treatments to reduce snoring if you are diagnosed with mild sleep apnea like weight loss, avoiding alcohol, caffeine and heavy meals and sedatives.

Oral Appliances - Recent studies show, patients with mild sleep apnea or unable to us C-PAP can use an molded oral appliance that is placed in the mouth at night to hold the lower jaw and bring the tongue forward. The appliance elevates the soft palate or retains the tongue to avoid falling back in the airway and blocking breathing by bringing the jaw forward.

Oral appliance should be checked by your oral & maxillofacial surgeon regularly to monitor compliance, to ensure the appliance is functioning properly and that symptoms are not worsening.

C-PAP (Continuous Positive Airway Pressure) and Bi-PAP (Bi-Level) - A C-PAP treatment can help patients with moderate OSA, using a mask that fits over the patient’s nose that moves pressured air to prevent the airway or throat from collapsing. This will prevent snoring and interruptions in breathing, but will not cure OSA. If you find you are unable to use these devices, don’t stop use without talking to your doctor, as your symptoms will return. Your oral & maxillofacial Surgeon can suggest other effective treatments.

Remember everyone’s nose and throat are shaped differently, so before surgery is considered your oral & maxillofacial surgeon will measure the airway and check for abnormal flow of air from the nose to lungs. Your doctor may choose one the following surgical procedures:

Uvulopalatopharyngoplasty (UPPP) – If the airway collapses at the soft palate, a UPPP may be performed on patients who are unable to tolerate the C-PAP. The UPPP procedure partially removes the uvula and reduces the edge of the soft palate to shorten and stiffen the soft palate.

Hyoid Suspension – If collapse occurs at the tongue base, a hyoid suspension may be use to secure the hyoid bone (U-shaped bone in the neck located above the level of the Adam’s apple) to the thyroid cartilage to help stabilize the region of the airway.

Genioglossus Advancement (GGA) – GGA treat obstructive sleep apnea by opening the upper breathing passage. This procedure tightens the front tongue tendon and reduces the degree of tongue displacement into the throat. This operation is often performed along at least one other procedure such as the UPPP or hyoid suspension.

Maxillomandibular Advancement (MMA) – MMA is a procedure that surgically moves the upper and lower jaws forward to open the upper airway. For some patients, the MMA is the only technique that can create the necessary air passageway to resolve their OSA.