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Snoring - Ladue News: Health-wellness

Snoring

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Posted: Thursday, October 28, 2010 12:00 am

        Finally, at the end of a busy day, it’s time for bed. We settle in, just drifting off to sleep—then comes the cocophany: your spouse’s snooring!

    According to Dr. Richard Maack of Synergi Facial Surgery, 40 percent of men and 26 percent of women snore, which leads to 23 percent of American couples sleeping separately to get a good night’s sleep. Snoring also causes headaches, exhaustion, clouded thinking, and decreased job productivity. “The problem with snoring is that it’s complex; it’s almost never due to just one factor.”

    He says snoring may be caused by problems with the palate, uvula, nose, tonsils, jaw or tongue. Things that make it worse include obesity, allergies and alcohol.

    Maack does two highly effective non-invasive procedures, both approved by the FDA for snoring. The first one, called the pillar procedure, involves inserting four or five flexible Dacron implants about three-fourths of an inch long into the soft palate. “This is the same material used in heart valves because the body doesn’t reject it,” he says. “The way the pillars work is to reduce the vibration and fluttering when we breathe. It has an 80 to 85 percent success rate.”

    In the second procedure, enlarged nasal turbinates are reduced in size through radiofrequency energy. Both procedures are done in the office under local anesthetic, do not involve cutting or sutures, and cause minimal discomfort. “People are skeptical about these procedures because they have seen decades of gimmicks that don’t work,” he says. “The FDA has approved them both specifically for snoring because they do work, however, insurance companies don’t consider noise a health issue.”

    Dr. Hamsa Subramanian of Allergy & Asthma Docs says snoring cuts across sexes and age groups. “It’s a myth that snoring affects only obese, middle-aged men. Even little children can snore, although the reasons for it differ. More important, snoring may be associated with sleep apnea, a serious condition that needs to be explored.” She says children who snore may have enlarged tonsils and adenoids, which can contribute to sleep apnea. Often both problems clear up when those obstructions are removed.

         Subramanian says that indeed, obesity can play a role, as can neck size, and that losing weight can help with the snoring. As an allergist in St. Louis, she finds a major culprit to be mouth breathing because of nasal congestion, both from allergic and non-allergic rhinitis. To solve the snoring problem, however, requires going after the cause. “Treatment will always be more effective if we know what’s causing it. I can work on the allergies and refer out for anything that needs surgery. Sleep studies can help rule out sleep apnea.”

    While not as comprehensive as a sleep center study, the take-home apnea screener she uses can give important information, and the patient is more likely to sleep in his own home. The patient is hooked up to a monitor for three consecutive nights, while the monitor checks oxygen saturation levels and records the snoring and the heart rate. A read-out and report help her determine the next steps. If sleep apnea is indicated as a possible cause, she refers the client to a sleep center for a definitive diagnosis. “If oxygen saturation and pulse are good, and we’ve ruled out allergy or sinus problems and any mechanical obstruction, I advise patients to avoid smoking or drinking alcohol late at night, and lose weight if that’s an issue,” Subramanian says. “If snoring is positional, their dentist can make them a snore guard, which advances the lower jaw to open up the throat. Getting to the cause of the problem allows us to come up with a useful treatment plan.”

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