Frequently Asked Questions About Snoring ( FAQ )
The following are questions most often asked of doctors about snoring and snoring treatment. If you have additional questions, you may care to ask doctors and patients by posting them to the Snoring Forum.
The noises of snoring are generated within the breathing passages.
The sounds are caused by the vibration or flapping of the tissues lining the air passages.
Noises can result from a narrowing of the nasal passage which generates a whistling noise. The vibration of the soft palate (or roof of the mouth) causes the fluttering vibration sounds. This may, in turn, have been caused by narrowness of the nasal passage causing turbulent or irregular air flow which contributes to the fluttering of the soft palate.
The tongue may fall back into the airway narrowing the airway and at times causing blockage. This may also contribute to the snoring noise.
It is most important to stress that snoring, in most patients, is due to multiple factors, each playing some part in the snoring process. Factors which are important in this regard include narrowing or blockage of the upper airway passages through anatomical or injury reasons as well as factors contributing to congestion of the soft tissues of the airways, e.g. smoking, alcohol, acid reflux from the stomach affecting the throat tissues, obesity, ageing and hormonal factors.
Snoring can contribute to fatigue and morning tiredness. This can add risks to driving and any occupation where workplace tiredness can lead to a lowering of safety. There appears to be an increased risk of high blood pressure and stroke in snoring patients.
Where snoring is accompanied by significant sleep apnoea, additional health risks may occur.
Snoring may be assisted by certain dental devices which bring the jaw forward. This does not help in all instances of snoring. Nasal appliances usually do not assist with snoring although they may give slight assistance with nasal airflow.
Surgical assistance may include nasal, palatal or tongue and neck surgery. The surgical procedure will depend on the location of the tissues contributing to snoring.
Nasal surgery may include improving the nasal airway by straightening the nasal septum (mid line nasal cartilage partition), shrinking the lining tissue of the nose, particularly where this has been troubled by allergy or by the removal of nasal polyps. Previous nasal injury involving the external nose and the nasal septum may require correction.
The flapping of the soft palate in snoring may be assisted by palatoplasty involving either high frequency radiowave or C02 laser surgery. Newer procedures for more severe forms of snoring including radiowave shrinkage of the back of the tongue as well as procedures to bring the tongue tissues forward may be of assistance in selected cases.
The removal of excess neck fat through liposuction or liposhaving techniques may contribute to assisting the control of snoring in some cases.
Where nasal airflow difficulties contribute to snoring, then nasal surgery alone may cure or significantly improve the symptoms in 30% of snoring patients. Those still snoring may require additional measures.
Most patients undergoing palatal surgery will experience a significant improvement in snoring. 70% to 80% of palatal surgery patients will have an improvement within two to three months of the initial procedure. Dependent on the technique, some patients may require supplementary surgery to further assist control of their snoring.
Nasal and palatal surgery can be performed on a Day Surgery basis. This may be performed either in a stand-alone surgical facility or within a hospital on a "go home the same day" basis according to the procedure.
Yes. Dependent on the surgery, continued problems can be assisted by further revision procedures. Palatal surgery may require between one and three procedures.
Nasal surgery is minimally uncomfortable. The main difficulty is blockage of the nasal airway for the first week after surgery and the dry mouth that results from this. Most discomfort is readily handled by simple pain medications such as Paracetamol (Panadol).
Surgery of the palate is variously painful dependant on the procedure and on the patient's individual pain thresholds or ability to withstand discomfort.
Radiowave treatment (submucosal radiowave palatoplasty) of the palate is usually discomfortable for up to two or three days ater the procedure, but the patient can usually return to work the following day.
Laser palatoplasty is a much more discomforting procedure. The discomfort may last up to a week but rarely longer. The operation itself is usually pain free following the establishment of a local anaesthetic. There may be some discomfort that evening. The pain experience may be more significant three to four days after the procedure itself. The painful period usuall ends by seven to ten days after the procedure. Pain control with medications will be required. The cause of the pain is the laser removal of the mucosa (surface lining of the palate). This is a similar experience to having two ro three large ulcers on the roof of the mouth. Discomfort can be experienced on swallowing. For more detailed information, seePost Operative Instructions.
Nasal surgery will cost approximately A$2000.00 including anaesthetic and hospital or day surgery charges.
Palatal surgery will cost between A$2000-3,000.00 including surgery, anaesthetic and hospital or day surgery charges.
A significant proportion of the costs will be re-imbursed through Medicare or Private Insurance. The above figures are indicative only and will vary from patient to patient according to what procedures are required. More exact cost details will be available at the time of consultation.
Up to half the total treatment costs will be covered through a combination of Government Insurance (Medicare) and private insurances.
Most procedures for snoring surgery can be done on a same day return to home basis. Overnight stays may be considered where this is appropriate for the patient's convenience.
Snoring correction will assist both socially and medically. Snoring is frequently disruptive to other members of the family. It frequently disrupts the sleep quality of the household members. Snorers may also be unpopular due to disturbance of room mates on holidays or business trips. Finally, snorers may be the subject of mild ridicule.
Assisting the medical problems related to snoring may also improve life quality. Snoring frequently causes restless sleep and tiredness on waking. It may also cause daytime drowsiness. More severe snoring may contribute to elevated blood pressure and, with this, increased risk of stroke.
It's difficult to make an individual prediction for a patient. Statistically, when large numbers of snorers are examined there would appear to be an increased risk of high blood pressure and the complications of this. Tiredness resulting from poor sleep due to snoring can lead to accidents particularly on the road and in the workplace.
Obstructive Sleep Apnoea (OSA) is a medical disturbance in which episodes of blockage of the upper airway occur during sleep. These are usually associated with a reduction in the level of blood oxygen saturation. This change in oxygen is felt to be the cause of tiredness and poor sleep quality.
Sleep Apnoea can be controlled by the use of CPAP breathing apparatus. In patients who are unable to tolerate this, then in certain instances nasal and oral pharyngeal surgery can be of assistance.
CPAP stands for Continuous Positive Airway Pressure. This involves sleeping with a pressure pump device which is supplied to a facial or nasal mask. Upper airway obstruction during sleep is prevented by the air pressure acting as a "pneumatic splint" which holds the airway open and thus prevents its collapse during sleep. The positive pressure is administered via a face or nasal mask which is hooked up to a pressure pump. Whilst the CPAP device can assist with simple snoring, it is usually felt to be too complicated to be used on a life-long basis. The more significant risks of sleep apnoea, however, do justify lifetime usage where this is tolerated by the patient.
Weight loss is an important part of the control of snoring. After surgery, weight loss may occur due to the initial post-surgical procedure discomfort contributing to loss of appetite.
Yes. Smoking contributes to congestion of the throat tissues. It also increases acid secretion in the stomach which can irritate the throat through reflux and cause additional congestion.
Alcohol, particularly in excess and particularly at night, can lead to increased snoring. Weight gain related to alcohol consumption may be an additional factor.
Weight control is an important part of any correction of snoring programme.
Nasal breathing is generally improved within one to two weeks after surgery.
Radiowave or laser surgery to the soft palate will generally take two to three months before improvement is noted. Additional procedures may be required to control snoring and these will be indicated at the time of consultation. Time must also be allowed for these additional procedures. Most patients can anticipate a good improvement in their snoring within two to four months. Any snoring after this period may require supplementary treatment.
Whilst most procedures will require one week’s convalescence after surgery, particularly for nasal or laser palatal procedures, the radiowave palatoplasty procedure when carried out as a separate operation may allow a return to work within one to two days.
The newer procedures for snoring are still being evaluated in terms of the duration of the improvement, however, some patients are already showing five year control of snoring after palatal surgery.
Nasal surgery generally gives a permanent improvement where this is sufficient to contribute to control of snoring.
Because snoring is a multi-factor medical condition, repeat or additional operations may be required as part of the management plan. Not all patients can anticipate 100% control of snoring although the majority of patients do have useful improvement.
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