Germán Sandoval, M.D., Otorhinolaryngologist Surgeon

Bucaramanga, Colombia

Occasional Snoring affects 45% of adults; permanent or frequent snoring affects 25% of adults. It affects children; in this case snoring is a major problem because of its clinical consequences and implications. Men suffer from it more than women do, but many women experience it after menopause. Over weight increases snoring threat and its danger to health.  

CAUSES

Snoring starts when air flow is obstructed through the superior respiratory ways. The zone in which uvula, tongue, part of the throat and soft palate are located is essential in snoring processes. This zone is called oropharynx. It is easily collapsible, and vibration of all its structures due to difficult or hard breathing produces snoring. 

There are many factors contributing to start or increase snoring problems: Overweight, obesity, short neck, facial osseous alterations, specially mandible problems, nasal obstruction due to turbinated bones, polyps or septum deviation, tonsil and adenoid hypertrophy (specially in children), too big, prominent soft palate and/or uvula, and a weak muscular tone in soft palate and/or uvula. 

CONSEQUENCES OF SNORING AND SLEEP APNEA  

Snoring alters sleep factors and deprives people of adequate night rest. Severe snoring together with some other symptoms, may indicate the existence of a syndrome called associated sleep apnea syndrome. It consists on temporary breathing suspension while sleeping (longer than 10 seconds). It may occur many times each night. 

Restless and interrupted sleep, along with a decrease of oxygen supply to the organism at night frequently cause: Day time somnolence, lack of attention and concentration, memory problems, bad mood, irritability, tiredness when awakening, sometimes accompanied by cephalalgia.  

Current research may even relate snoring and sleep apnea with hypertension, impotence, early senile dementia, and sudden death. 

SURGICAL TREATMENT OF SNORING  

Provided a good diagnosis and adequate selection of patients, surgery reduces snoring in more than 75% of cases, also, it reduces sleep apnea, in a smaller percentage. Doctors must choose patients that respond better to this procedure. 

Otorhinolaryngologists find the particular causes of snoring, by a nasopharyngeal-laryngeal videoendoscopy. Consequences related to sleep apnea must be established by sleep exams (polysomnographic tests) 

A good diagnosis allows doctors to select patients that will be excellent candidates for surgery. These are the available surgical procedures: 

-  Uvulopalatopharingoplasty, or partial resection of the soft palate.

-  Laser uvulopalatoplasty.

-  Somnoplasty by radio-frequency.

-  Tonsillectomy, with or without adenoidectomy . 

-  Nasal Surgery: Septum deviations, nasal polyps, etc. 

-  Maxillary and facial surgery, surgery of the tongue base. 

-  Tracheostomy

WHAT TO DO IF YOU SUFFER FROM SPORADIC OR MILD SNORING

You can take some sleep “hygiene” measures that will help diminish or eliminate this problem: Lose weight, do physical exercise, avoid alcohol, tobacco and big meals at night, establish regular sleep patterns, do not sleep face upward (it increases snoring).

Another option consists on an intra-oral device, recommended by your otorhinolaryngologist, that allows some mandible movement forward, helping tongue stay in adequate positions that improve air flow or make it free. Early consulting with your physician will improve your sleep…and your whole family’ s sleep.

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