| Tuesday, October 31, 2006
| SNORING: NOT FUNNY, NOT HOPELESS
|Forty five percent of normal adults snore at least occasionally, and 25 percent are habitual snorers. Problem snoring is more frequent in males and overweight persons and it usually grows worse as people age.
More than 300 devices are registered in the U.S.Patent and Trademark Office as cures for snoring. Some are variations on the old idea of pinning a sock that holds a tennis ball on the pajama back yo force the snorer to sleep on his side. (snoring is often worse when the person sleeps on his back.) Some devices reposition the lower jaw forward; some open nasal air passages; a few others have deen designed to condition a person not to snore by producing unpleasant stimuli when snoring occurs. But if you snore, the truth is that it is not under your conscious or unconcious control; if anti snoring devices work, that is probably because they keep you awake.
WHAT CAUSES SNORING?
The noisy sounds of snoring occur when there is an obstruction to the free flow of air through the passages at the bacj of the mouth and nose. This area is the collapsible part of the airway, where the tongue and upper throat meet the soft palate and uvula. When these structures striek each other and vibrate during breathing, that is snoring.
PERSONS WHO SNORE MAY SUFFER FROM:
#poor muscle tone in the tongue and throat.
When muscles are too relaxed, either from alcohol or from drugs that cause sleepiness, the tongue falls backwards into the airway or the throat muscles draw in from the sides into the airway. This can also happen in deep sleep.
#excessive bulkiness of throat tissue.
Children with large tonsils and adenoids, for example, often snore. Overweight person have bulky neck tissue, too. Cysts or tumors could also cause bulk, but they are rare.
#long soft palate and/or uvula.
A long palate narrows the opening from the nose into the throat. As it dingles, it acts as a noisy flutter valve during relaxed breathing. A long uvula makes matters even worse.
#obstructed nasal airways.
A stuffy or blocked nose requires extra effort to pull air through it. This creates an exaggerated vacuum in the throat, pulls together the floppy tissues of the throat, and snoring results. So, in some persons snoring might occur only during the hay fever season or with a cold or sinus infection.
Also, deformities of the nose or nasal septum, such as a deviated septum (a defromity of the wall that separates one nostril from the other), can cause such an obstruction.
IS SNORING SERIOUS?
Socially -- yes.
It can be, when it makes the snorer the object of ridicule and causes others sleepless nights and resentfulness.
Medically - yes.
It distrubs the sleeping pattern and deprives the snorer of appropriate rest. When snoring is severe, it can cuase serious long term health problem.
When loud snoring is interrupted by frequesnt episodes of totally obstructed breathing, it is known as obstructive sleep apnea. Significant episodes last more than 10 seconds each and occur more than 7 times per hour. These episodes can reduce the blood oxygen level, which causes the heart to pump harder.
The immediate effect of sleep apnea is that the snorer is forced to sleep lightly to keep his muscles tense in order to maintain airflow to the lungs. Because such a snorer does not get enough deep restful sleep, he awaken unrefreshed, is drowsy in the daytime, is a hazardous (sleepy) driver, and his work effectiveness may suffer. After many years with the disorder, elevated blood pressure and heart enlargement may occur.
DIAGNOSIS, PROGNOSIS, AND TREATMENT
Can Heavy Snoring Be Cured?
Heavy snorers, those who snore in any position or who are disruptive to the family, should seek medical advice to ensure that sleep apnea is not a problem. An otolaryngologist will provide a thorough examination of the nose, mouth, throat, palate, and neck. A sleep study in a laboratory enviroment may be necessary to determine how serious the snoring is and what effect(s) it has on the snorer's health.
Treatment depends on the diagnosis. An examination will reveal if the snoring is caused by obstructive sleep apnea, nasal allergy, infection, deformity, or tonsils and adenoids.
Snoring or obstructive sleep apnea may respond to various treatments now offered by many otolaryngologist head and neck surgeons:
# Uvulopalatoharyngoplasty (UPPP)
is surgery for treting obstructive sleep apnea. It tightens flabby tissues in the throat and palate and expands air passages.
# Thermal Ablation Palatoplasty (TAP)
refers to procedures and techniques that treat snoring and some of them also are used to treat various severities of obstructive sleep apnea. Different types of TAP include bipolar cautery, laser, and radiofrequency. Laser Assisted Uvula Palotoplasty (LAUP) treats snoring and mild obstruvtive sleep apnea by removing the obstruction in the airway. A laser is used to vaporize the uvula and a specified portion of the palate in a series of small procedures in a doctors's office under local anasthesia.
Radiofrequency ablation - some with temperature control apporved by the FDA - utilizes a needle elctrode to emit energy to shrink excess tissue to the upper airway including the palate and uvula (for snoring), base of the tongue (for obstructive sleep apnea), and nasal turbinates (for chronic nasal obstruction).
# Genioglossus and hyoid advancement
is a surgical procedure for the treatment of sleep apnea. It prevents collapse of the lower throat and pulls the tongue muscles forward, thereby opening the obstructed airway.
If surgery is too risky or unwanted, the patient may sleep every night with a nasal mask that delviers continouous positive airway pressure (CPAP) into the throat.
A chronically snoring child should be examined for problems with his or her tonsils and adenoids. A tonsillectomy and adnoidectomy may be beneficial to return the child to full health.
SELF HELP FOR MILD SNORER
Adults who suffer from mild or occasional snoring should try the following self help remedies:
1.) Reduce weight with an athletic lifestyle and healthy eating habits.
2.) Avoid tranquilizers, sleeping pills, and antihistamines before bedtime.
3.) Avoid alcohol for at least 4 hours before bedtime and heavy meals or snacks for 3 hours before retiring.
4.) Establish regular sleeping patterns.
5.) Sleep on your side rather than back.
6.) Tilt the head of your bed upwards 4 inches.
Remember, snoring means obstructed breathing, and obstruction can be serious. It's not funny and its not hopeless.
(Source: American Academy of Otolaryngology - Head and Neck Surgery)
|posted by infraternam meam @ 10:38 PM
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