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Snoring & Sleep Disorders

Many people consider snoring a minor annoyance, but it can signal a potentially serious condition called sleep apnea (temporary interruptions in breathing during sleep). An article in the June 13, 2001, issue of JAMA reports an association between sleep-disordered breathing and a generic marker called apolipoprotein E 4. The authors speculate that this marker may be one of the many genetic factors that make someone susceptible to developing sleep-disordered breathing.

Sleep apnea is disturbed or interrupted breathing during sleep. For those affected by sleep apnea, there can be many temporary interruptions in breathing, each usually lasting about 10 seconds, throughout the sleep period. These interruptions in breathing can occur as often as 20 to 30 times per hour.

Because some of the symptoms of sleep apnea occur during sleep, they may be recognized first by people with whom one shares living quarters.
* Heavy snoring, although not everyone who snores has sleep apnea
* Struggling to breathe during sleep<br>* Interruption in breathing during sleep followed by a snort when breathing begins again
* Being excessively sleepy during the day
* Falling asleep during activities that require attention and concentration, such as driving, working, or talking If you are experiencing these symptoms, see a doctor, you may have sleep apnea or some other condition that needs medical attention.

 Obstructive – partial or complete obstruction of the airway, which can be caused by relaxation of the muscles of the throat, soft palate, and tongue during sleep
* Central – problems with signals from the brain that control breathing Risk factors for sleep apnea include
* Being overweight
* Having a physical abnormality in the nose, throat, or other parts of the upper respiratory tract
* Having high blood pressure

For mild cases of sleep-disordered breathing one can
* Sleep on one’s side instead of back
* Avoid drinking alcohol before sleeping
* Avoid using sleeping pills
* Avoid smoking or using other tobacco products
* Lose weight, if overweight

The most common medical treatment for sleep apnea is continuous positive airway pressure (CPAP) , which is a therapy that uses pressure from an air blower to circulate air through the nasal passages and upper airway. The patient wears a mask over the nose that is connected to the air pressure hose, and the air pressure is adjusted to keep the airway open during sleep. Other therapies include dental appliances that change the position of the jaw and tongue. Snoring or obstructive sleep apnea may respond to various surgical treatments now offered by many Otolaryngologist- Head and Neck surgeons:
* Uvulopalatopharyngoplasty (UPPP) is surgery for treating obstructive sleep apnea. This procedure removes soft tissue on the back of the throat and palate, thereby increasing the width of the airway at the throat opening.
* Laser-Assisted Uvula Palatoplasty (LAUP) treats snoring and mild obstructive 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 doctor’s office under local anesthesia.
* Somnoplasty is a minimally invasive procedure that occurs in an outpatient environment. It utilizes a needle electrode to emit radiofrequency 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.
* Nasal Surgery – Nasal obstructions such as a deviated septum may play a role in sleep apnea, and can be corrected through appropriate surgical procedures.