SNORING: TREATMENT OPTIONS
Snoring is the result of vibrations in the soft palate and uvula during sleep. Prior to treatment in our office, we will determine whether you have simple snoring (i.e., snoring without apnea) or Obstructive Sleep Apnea (OSA). While snoring appears to run in families, the volume of snoring varies depends on the individual. If you snore, you may wake up in the morning with a dry mouth and/or a sore throat. In addition to waking you during the night (even if you don’t know it), the noise of your snoring may prevent your bed partner and others in your household from enjoying the benefits of deep, uninterrupted sleep.
Non-Surgical, Dental Treatment Options
Oral Appliance Therapy
Oral appliance therapy is extremely effective in managing simple snoring for the snorer as well as his or her bed partner. Briefly, there are two different types of sleep appliances that can be used to treat simple snoring:
- A mandibular advancement device works by moving your lower jaw forward slightly. This, in turn, tightens the soft tissue and muscles of your upper airway to prevent obstruction during sleep.
- A tongue retaining device prevents your tongue from falling against the back of your throat and blocking your airway. Although it can be effective, use of this type of device is far less common than mandibular advancement devices.
To be effective, an oral sleep appliance must be precision-fit for each patient by an experienced dentist who is fully versed in dental sleep medicine practice parameters and protocols. Because an oral sleep appliance works by bringing your lower jaw forward, it is also important that the dentist who prescribes your oral sleep appliance have a complete understanding of the jaw joint (i.e., TMJ disorders).
Follow-up appointments during which your appliance will be inspected for wear and fit-checked, the health of your oral structures and integrity of your occlusion will be evaluated, and you will be reassessed for worsening signs of OSA, are also a vitally important part of treatment in our office.
Complementary Health & Wellness Strategies
Additional strategies Dr. Bailey may recommend in conjunction with use of an oral appliance to manage simple snoring include, but are not limited to, the following:
- Weight Loss - Studies show that losing as few as 10 pounds may be enough to make a difference.
- Sleep Position Change - People tend to snore more when they sleep on their backs; sleeping on your side may be helpful.
- Dietary Changes - Avoid consumption of alcohol, caffeine and heavy meals, especially within two hours of bedtime.
- Tobacco Cessation Program - Tobacco use causes inflammation to the throat and, therefore, should be eliminated. (We have recommended tobacco cessation programs and other stop-smoking strategies to patients with great success.)
- Daily Mouth Exercises - Daily exercises for your tongue and upper airway can help improve snoring and sleep apnea when done faithfully each night, approximately 20 minutes before bedtime.
Surgical Treatment Options
Generally speaking, snoring is best managed conservatively and without surgery, which inherently causes risks. To be sure that you are well informed about all of your options, we have included some of the more common surgical procedures for snoring here.
- Tonsillectomy - Enlarged tonsils and adenoids can cause snoring and sleep apnea in children. As such, the one exception to our caution against surgery for the treatment of snoring (and Obstructive Sleep Apnea) is tonsillectomy, which has proven very successful in eliminating sleep-disordered breathing in children. We urge you to consult Dr. Bailey for an opinion as to whether removal of your child’s tonsils would be beneficial.;
- Laser-Assisted Uvuloplasty (LAUP) - This is a surgical procedure that opens the airway behind the soft palate by removing the uvula and surrounding tissue. It is typically performed by an oral & maxillofacial surgeon with local or general anesthesia.Note: LAUP surgery is painful and the true success rate appears to be in the range of 30-50%. In most cases, snoring is reduced but not eliminated. In addition, the results are not permanent and some studies show that LAUP surgery can cause or worsen sleep apnea. We, therefore, urge patients to seek a second opinion before undergoing LAUP.
- Uvulopalatopharyngoplasty (UPPP) - UPPP surgery involves surgically removing all or part of the uvula (the soft flat of tissue that hangs down in the back of your mouth), parts of your soft palate and throat tissue behind it, plus your tonsils and adenoids. The goal of UPPP surgery is to increase the width of the airway at the throat’s opening, block some muscle action to improve the ability of the airway to remain open and improve the movement and closure of the soft palate. Note: Studies suggest that UPPP surgery success rate is 50% or less over the long term. It is also very painful and has been associated with a number of very serious complications. The American Association of Sleep Medicine recommends that patients try non-surgical treatment options, such as the oral appliance therapy we provide in our office, before undergoing UPPP.
- Palatal Implants (aka: “Pillar Procedure”) - This procedure involves having a doctor inject braided strands of polyester filament into your soft palate to stiff it and reduce snoring. Note: Although palatal implants have not been shown to result in any serious side effects, the benefits and safety of this procedure are still being studied.
- Radio Frequency (RF) Tissue Ablation (somnoplasty) - This treatment for snoring uses radio waves to shrink the tissue in the throat or tongue, thereby increasing the space in the throat and making airway obstruction less likely. Over the course of several treatments, the inner tissue shrinks while the outer tissue remains unharmed. Note: Several treatments may be required and the long-term efficacy of this procedure has not been determined. Additionally, since all surgery has inherent risks, we urge patients to seek a second opinion before undergoing Radio Frequency for treatment for snoring.