Sleep Apnea
Sleep apnea is a disorder in which breathing is interrupted periodically throughout the night. These pauses, or gaps, in breathing may be accompanied by choking or gasping but rarely awaken the sleeping individual. An estimated 18 million Americans suffer from sleep apnea, many of them unaware of their condition.
What Causes Sleep Apnea?
There are two main types of sleep apnea: obstructive and central. Obstructive sleep apnea occurs when the throat muscles relax and droop during sleep, blocking the airway and causing breathing difficulty. It is by far the most common form of the disorder. Central sleep apnea is the result of the brain failing to properly control breathing during sleep; this is rare.
The main sign of sleep apnea is chronic, loud snoring. Symptoms include daytime drowsiness, lack of concentration, memory loss, irritability and depression. You may experience frequent morning headaches and sore throats and wake up with a dry mouth.
Those who are male, overweight and older than the age of 40 are most at risk, though sleep apnea can – and does – affect people of both sexes and all ages. Other factors that can contribute to sleep apnea include natural aging, excessive or bulky throat tissue, large soft palate or uvula, small jaw, large neck and oversized tonsils or adenoids.
Allergies, sinus infections, tobacco use and alcohol all may play a role as well.
How Is Sleep Apnea Treated?
Sleep apnea is more than just a nuisance that robs you of sleep. Left untreated, it can lead to serious health issues such as congestive heart failure, stroke, heart attack, high blood pressure and cardiac arrhythmia. If you suspect you are suffering from sleep apnea, schedule a visit with your physician who will perform a thorough physical examination and may set up a sleep study test.
You may be able to reduce the severity of your symptoms by implementing certain lifestyle changes. Try losing weight, cutting back or eliminating alcohol (especially before bedtime) and quitting smoking. Sleeping on your side instead of your back and elevating your head may also help.
The preferred method of treatment for sleep apnea is continuous positive airway pressure (CPAP). This involves controlled bursts of air pumped into your throat while you sleep, delivered through a mask that is worn over the nose and mouth and attached to a machine. Other options for treatment include oral mouth guards that reposition the lower jaw and tongue, nasal breathing strips and surgery.
Snoring
Snoring is extremely common: 45 percent of American adults snore occasionally, and 25 percent are habitual snorers. While many consider it a mere nuisance, snoring is actually a sleep disorder that can be the sign of a serious medical condition.
What Causes Snoring?
When you sleep, your tongue, throat muscles and soft palate relax. If they relax too much, they can droop backward and block the airway, vibrating together when you breathe. This causes the telltale noisy sounds associated with snoring. The more the airway is obstructed, the louder the snoring will be.
There are several factors that increase the odds you will snore. People with bulky throat tissue or an enlarged soft palate are more at risk for snoring, as are those who experience frequent nasal congestion, have a deviated septum, nasal polyps, enlarged tonsils or adenoids as well as those who drink alcohol before bedtime.
The typical snorer is overweight, male and over the age of 40. Snoring tends to worsen with age. In some individuals, the airway becomes so obstructed that breathing is interrupted; this leads to a serious medical condition known as sleep apnea.
Tips for Quieting Your Snoring
If your snoring isn’t a complication of sleep apnea, implementing lifestyle changes may help eliminate the problem. Useful tips include:
- Sleeping on your side instead of your back.
- Losing weight.
- Avoiding alcohol before bedtime.
- Treating allergies.
- Eliminating tobacco smoke.
If lifestyle modifications do not solve the problem, oral appliances that reposition the lower jaw may help. Another alternative is nasal breathing strips. Some individuals might benefit from surgical techniques such as:
- Uvulopalatopharyngoplasty (UPPP). Excess throat tissue is surgically removed to enlarge the airway. This may include the uvula, soft palate, tonsils, adenoids and/or pharynx.
- Laser Surgery. Lasers are used to remove the uvula and excess tissue from the soft palate.
- Inspire. Inspire works inside your body while you sleep. It’s a small device placed during a same-day, outpatient procedure. When you’re ready for bed, simply click the remote to turn Inspire on. While you sleep, Inspire opens your airway, allowing you to breathe normally and sleep peacefully.
UPPP
Uvulopalatopharyngoplasty (UPPP) is a surgical procedure to remove excess tissue in the throat in order to widen the airway, making it easier to breathe. It’s designed to treat obstructive sleep apnea, a sleeping disorder that can cause serious health problems over time.
Why UPPP?
UPPP involves removal of tissues that may include the uvula, soft palate, tonsils, adenoids and pharynx. In some instances, a small portion of the tongue may be removed as well.
If you suffer from snoring and sleep apnea due to excess tissue in the throat or mouth that causes blockages of the upper airway, are unable (or unwilling) to use continuous positive airway pressure (CPAP) – the preferred method for treating sleep apnea – or do not respond to CPAP treatment, you may be a candidate for UPPP.
The Procedure
During the procedure, the patient is given general anesthesia. The surgeon will remove the tonsils and adenoids (if applicable), excise the uvula and trim or remove the soft palate. The cuts are sutured together with stitches. A brief hospital stay may be recommended so the patient can be closely monitored immediately after surgery.
Complications may include sore throat, swelling, infection, bleeding, difficulty swallowing, speech problems or changes to the voice, sleepiness or apnea due to medications you’ll be given to promote healing, changes in the way food tastes and narrowing of the airway related to scar tissue.
As with other sleep disorder surgeries, UPPP is not a viable solution for everybody. It offers mixed results; some people report a drastic reduction in episodes of snoring and apnea, while others still require additional treatment (e.g. CPAP) afterwards. Your doctor can discuss the risks, and help you to decide whether UPPP is right for you.
Call The ENT Center of Central Georgia at (478) 743-8953 for more information or to schedule an appointment.
