Snoring & Sleep Apnea 


Snoring is a sound produced by vibration of the soft tissues of the upper airway during sleep and is indicative of increased upper airway resistance. Studies estimate that half of men and one third of women snore on a regular basis. It can affect not only the snorer’s sleep but also the sleep of a spouse or other family members nearby. In fact, snoring causes many couples to sleep in separate rooms and often places strain on marriages and relationships. Recent evidence suggests that snoring may even cause thickening of the carotid arteries over time due to vibration trauma and potentially increase risk of stroke.

Snoring also may be a sign of a more serious condition known as obstructive sleep apnea (OSA), characterized by a repetitive stopping or slowing of breathing that can occur hundreds of times through the night.
Identification of this problem could be a life savor. Make sure to talk to your doctor about your sleep habits. If you are high risk for Sleep Apnea, a proper ENT evaluation is needed.

Treatment options for SNORING
1- Nasal Blockage Treatment
Increased nasal congestion has been shown to cause or contribute to snoring. Nasal obstruction may result from many causes including allergies, polyps, septal deviation, and turbinate hypertrophy (known as congestion) . Medical treatment options, such as a nasal steroid spray or allergy management is helpful in most patients. Structural problems, such as a deviated septum, often benefit from surgical treatment.

One surgical option, known as radiofrequency turbinate reduction (RFTR), can often be performed in the office setting under local anesthesia. RFTR uses radiofrequency heat to shrink swollen tissues in each side of the nose. Other nasal surgeries, including septoplasty and polyp removal, are usually performed in the operating room under general anesthesia. In select patients, treatment of nasal congestion can result in improvement or resolution of snoring.

2-  Palatal stiffening procedures:
There are different ways of hardening of the soft palate to prevent vibration of tissue causing the snoring. These procedures are: 

Laser treatment ( Night-Lase )

Fotona’s NightLase® therapy is a non-invasive, patient-friendly laser treatment for increasing the quality of a patient’s sleep. NightLase reduces the effects of sleep apnea and decreases the amplitude of snoring by means of a gentle, laser-induced tightening effect caused by the contraction of collagen in the oral mucosa tissue.

Treatment is done in 3 sessions , 2 weeks apart , lasting for 20 minutes . there no pain during or after and no down time. Could be covered under insurance.

• Radiofrequency
Radiofrequency treatment, also an office-based procedure performed under local anesthesia, uses heat to stiffen portions of the soft palate. Multiple treatment sessions may be required to achieve the desired results. This could be combined with Uvulectomy ( excision of the dangly tissue in the back of the throat) if indicated. This is the most cost effective way to dealing with snoring.
• Palatial Implants
Palatal implant therapy, also known as the Pillar procedure, involves the placement of three polyester implants into the soft palate under local anesthesia in the office. The implants, in conjunction with the body’s scarring response, result in stiffening of the palate, and subsequently, less vibration and flutter that causes snoring. The primary drawback is the relatively high cost of the implants. Press on LINK for more information

• Injection Snoreplasty
In this method, also done under local anesthesia in the office, a chemical is injected into the soft palate. The subsequent inflammation and scar tissue stiffen the palate, therefore, decreasing vibration and snoring. Injection snoreplasty is associated with more pain and recovery time. Some patients may also require additional injection treatments to achieve optimal results.

3- Tonsillectomy/adenoidectomy
 Enlarged tonsils and adenoids are a common cause of snoring and sleep disruption in children. The tonsils are clusters of lymphoid tissue in the back of the throat while the adenoids are a similar mound of tissue in the back of the nose. Although less commonly a problem in adults, some adults can receive excellent resolution of snoring through removal of enlarged tonsils and/or adenoids


Snoring - Wikipedia, the free encyclopedia




SLEEP APNEA  Treatment options 


Sleep Apnea is diagnosed by sleep study , Polysomnogram PSG. We prefer home based PSG due to confort, lower cost, patinet's tolerance and that is done over many nights which increases accuracy. Once we have established a diagnosis of sleep apnea following a sleep study (Polysomnogram), the treatment is tailored based on the severity of sleep apnea and patient's symptoms. The treatment options are :

1-Lifestyle Modifications: These include weight loss and exercise can help to improve sleep apnea and its related health problems.  Sleep positioning with sleeping on the side and using Tennis shirts ( Tennis ball is placed in a back pocket to prevent sleeping on the back) can be of  in mild or moderate sleep apnea. Oral exercises have also gain some popularity, but usually they are effective in mild cases of sleep apnea.
 2- CPAP: The most common and effective nonsurgical treatment for sleep apnea is Continuous Positive Airway Pressure or CPAP which is applied through a nasal or facial mask while you sleep.  The CPAP device does not breathe for you.  Instead, it creates a flow of air pressure when you inhale that is strong enough to keep your airway passages open.
 3- Oral Appliances: also known as mouth guard,  have also been found to be effective in selective cases. We offer this option in our practice with goor result. Insurance coverage can be an issue . Also, it might cause jaw pain and dental problems.
4- Surgery:  In cases when non-invasive treatments fail, a surgical solution might be necessary. Sleep apnea and snoring are a LOUD killers if not treated. That is why treatment is a must. Surgery type can vary significantly between a patient and another. These surgeries option can be done isolated or in combination: Nasal surgery, Removal of Tonsils and Adenoids, Reduction of soft palate and uvula , Tongue reduction and advancement and multiple types of jaw surgeries. Dr. Srour is well known in the area for his motivation and interest in helping sleep apnea patients. Upon consultation treatment options will be discussed to fit the specific presentation and findings.

5- Surgically implantable nerve stimulators:  

IThis is a new modality that gaining some interest between physicians . To Know that you will need multiple surgical procedures with an implantable device that will need to be activated at night and deactivated in the morning. This is a modality of treatment that still in its infancy , there is a lot to be learned and improved. 

To read more press on: SLEEP APNEA


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