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Snoring
Snoring is the vibration of respiratory structures
and the resulting sound, due to obstructed air movement
during
breathing while
sleeping. The sound may be soft or loud and unpleasant.
The structures are usually the
uvula and
soft palate. The irregular airflow is caused by a
blockage, due to causes including:
Throat weakness causing the throat to close during
sleep
- Mispositioned jaw, often caused by tension in muscles - Fat gathering in and around the throat
- Obstruction in the nasal passageway
Statistics on snoring are often contradictory, but at
least 30% of adults and perhaps as many as 50% of people in
some demographics snore.[
Ordinarily, snoring is recognized by a friend or partner
who observes the patient sleeping. Besides the 'noise' of
snoring, more complex conditions such as
sleep apnea can be consistent with the symptom of
snoring. A sleep study can identify such issues. Patients
can also assess their own condition to determine the
likelihood of such problems based on the severity of their
sleeping disorder.
Treatment
Almost all treatment for snoring revolves around clearing
the blockage in the breathing passage. This is the reason
snorers are advised to
lose weight (to stop fat from pressing on the throat),
to stop
smoking (smoking weakens and clogs the throat), and to
sleep on their side (to prevent the tongue from blocking the
throat).
Dental appliances
Specially made dental appliances such as a
mandibular advancement splint, which advance the lower
jaw slightly, and thereby pull the tongue forward, are a
preferred mode of treatment for social snoring. Typically, a
dentist specializing in sleep apnea dentistry is consulted.
Such appliances have been proven to be effective in reducing
snoring and sleep
apnea, however side effects include the possibility that
a patient's bite could be altered.
Over-the-counter dental appliances may provide the same
benefits if fitted correctly. They are usually made from an
EVA polymer and are similar in appearance to protective
mouth-guards worn for sports. One disadvantage of the
cheaper devices compared to the professionally fitted
devices is the difficulty in setting up the correct jaw
position. An over-advanced jaw results in jaw joint pain,
whilst an under-advanced jaw produces no therapeutic effect.
The professionally fitted devices generally incorporate an
adjustment mechanism so that jaw advancement can be easily
increased or decreased after fitting. To adjust the "do it
yourself" appliances it is necessary to reheat them and mold
them again in the desired new position.
In the United States, the devices are considered class 2
medical devices and cannot be legally sold without a
prescription. In Australia, manufacturers can obtain
approval from the TGA (Therapeutic Goods Administration)
allowing the devices to be sold via normal retail channels,
without the involvement of a doctor.
Possible side effects of dental appliances include
Temporomandibular joint disorder (TMJD). TMJD is an
inflammation of the temporomandibular joint (jaw joint)
which can be very painful and is sometimes, although very
rarely, irreversible.
Surgery
Surgery is also available to correct social snoring. Some
procedures, such as
uvulopalatopharyngoplasty attempt to widen the airway by
removing tissues in the back of the throat including the
uvula and
pharynx. These surgeries are quite invasive, and there
are risks of adverse side effects. The most dangerous risk
is that enough scar tissue could form within the throat as a
result of the incisions to make the airway more narrow than
it was prior to surgery, diminishing the airspace in the velopharnyx. Scarring is an individual trait. It is
difficult for a surgeon to predict how much a person might
be predisposed to scarring. Some patients have reported that
they developed severe sleep apnea as a result of damage to
their airway caused by pharnygeal surgeries. At the present
time, the American Medical Association does not approve of
the use of lasers to perform operations on the pharnyx or
uvula.
Radiofrequency ablation (RFA) is a relatively new
surgical treatment for snoring. This treatment applies
radiofrequency energy and heat (between 77°C to 85°C) to the
soft tissue at the back of the throat, such as the soft
palate and uvula, causing scarring of the tissue beneath the
skin. After healing, this results in stiffening of the
treated area. The procedure takes less than one hour, is
usually performed on an outpatient basis, and usually
requires several treatment sessions. Discomfort and pain is
usually minimal. Radiofrequency ablation is frequently
effective in reducing the severity of snoring, but, often
does not completely eliminate snoring.
Positioning
Snoring can be reduced by changing position on the bed;
Sleeping on the side is a possible solution, to avoid
rolling back it is possible to place a pillow or a "ball" on
the back; raising the head is also another option, useful
both while lying on the back or for supporting the head
while lying on the side.
Other treatments
Devices such as nose clips can dilate the nostrils and
other devices can alter jaw mechanics to keep the jaw in an
optimum position. Different aids and practices may work for
different people. According to the British Medical Journal,
playing the
didgeridoo can also help, as it increases muscle usage
in the throat.
However, snoring is a recognized medical problem and people
who snore should always seek professional medical advice
before relying on techniques which may mask symptoms (i.e.
snoring) but not treat the underlying condition.
Source: Marketdata Enterprises, Inc. research, Wikipedia
*page last updated 05/05/2008
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