Snoring and Sleep Disorders

Many people snore loudly, preventing many a sleeping partner from getting a good night’s sleep. Forty-five percent of adults snore at least occasionally. Snoring occurs when the narrow airway of the palate or back of the tongue vibrates as air passes through.

A more serious condition called obstructive sleep apnea (OSA) can arise when loud snoring is interrupted by episodes of stopped breathing, as the airway becomes completely blocked during deeper sleep. The brain becomes starved of oxygen for a brief period, and it reacts by partially awakening the person, alerting him or her to reposition the jaw to open up the airway. This cycle may happen dozens of times during the night. During these obstructive episodes the heart strains to pump harder. This can cause serious health effects such as irregular heartbeats, elevated blood pressure and heart enlargement. Another significant side effect of OSA is that with such poor quality sleep, patients are also often sleepy and less mentally attentive during the day.

Loud snoring and obstructed breathing is more frequent in males, overweight persons, those with a larger neck size, or a recessive lower jaw. Snoring and sleep disorders generally worsen with age. Medical advice should be sought for heavy snoring or suspected obstructive sleep apnea. A snoring child should also be thoroughly examined for deformities of the airway.

Treatment for Snoring and Sleep Disorders

Fortunately, the majority of those with snoring or sleep disorders can be helped. Once Dr. Stout has evaluated you by examination, X-rays, and often a sleep study, he can identify the cause of snoring and determine which treatments are best suited for your condition. Other specialists may be called in to address specific treatment needs. Here are some of the common treatments for snoring or obstructive sleep apnea:

Lifestyle changes. We recommend adopting an active lifestyle, taking part in daily exercise, and losing excess weight. In addition, we may recommend treatments to improve nasal airflow with humidified air, nasal decongestants or adhesive strips, antihistamines, or nasal steroids.

Snoring appliance. An oral appliance is a mouthpiece that is inserted before going to sleep and acts to maintain or advance the position of the lower jaw and prevent the tongue from falling backward during sleep. Oral appliances can be effective in the treatment of sleep disorders for some, but not all patients. They are generally better tolerated than CPAP machines and more convenient for travel. Cheap versions of these devices are often advertised, but the most effective devices are the ones made by the dentist and custom fit to your teeth.

Re-contouring of the soft palate. Removal of the uvula and shortening the length of the soft palate can easily be performed under sedation in our office. This treatment can be effective in reducing snoring, but not as effective at treatment of obstructive sleep apnea.

Removal of mandibular tori. Starting in late teens and throughout adult years, some people develop extra layers of bone in the inside of the lower jaw under the tongue. The result is a slowly increasing volume of bone that pushes the tongue posteriorly and narrows the airway. Surgical removal of these tori can be easily accomplished in our office, and creates additional space for the tongue. This can significantly improve snoring and sleep apnea symptoms.

Large mandibular tori on the inside of the lower jaw.

Nasal airway surgery. Mouth breathing caused by obstructed nasal passages nearly always worsens snoring and sleep apnea. Stuffy nasal passages and restricted breathing require the mouth to open during sleep. When the mouth is open, the hinging movement of the lower jaw moves the tongue backwards, resulting in a slightly narrower airway. This narrowing may be just enough to cause snoring or worsening of the airway. Surgeries of the nasal tissues and passages are designed to eliminate obstructions in the nasal airflow.

CPAP device. The CPAP (continuous positive airway pressure) machine is a mask and airflow device that maintains the airway opening during sleep. CPAP machines are quite effective, but they can be clumsy to use, disruptive to sleeping partners, and poorly tolerated during the night.

Corrective jaw surgery. Surgically advancing both the upper and lower jaws brings the jaws and the tongue forward to open up the airway and improve airflow. This surgery is reserved for patients with severe OSA.

Few things in life are more pleasant than a good night’s sleep. If you or your sleeping partner suffer from significant snoring or sleep disorders, Dr. Stout will find a treatment that helps you stop snoring and start getting a great night’s sleep.