Snoring

Snoring is a nuisance for millions of not-snoring partners in Germany. Very often, the snoring person is oblivious to his own snoring. Besides, a lot of people make fun of sleep disorder, eventhough the topic itself is not that funny. It can cost people several years of their lives if they suffer from untreated heavy snoring with recurring pauses (obstructive sleep apnoea) during their sleep.

During sleep, the pharyngeals muscles slacken, thus leading to a narrowing of the posterior throat area. This leads to a blockage of airflow. The increased air pressure neccessary to overcome this obsticle then leads to a changed velocity of the air flow and a vibration of the soft tissue creating the typical sounds of snoring. In addition pauses in breathing asociated with gasping or choking sounds may occure.

 

Main Causes of Snoring

 

Obesity is one of the most frequent causes and at the same time one of the most difficult to treat. Another important, but often underestimated cause, is a lack of sleep.

 

Diagnostic Examinations Possible:

  • inspection of the nose and oral cavity
  • endoscopy of the nasopharynx, the main nasal cavities, the base of the tongue and the larynx
  • flow measurement of both nasal cavities
  • optional ultrasound assessment of the maxillary sinuses with chronic nasal inflammation

Diagnosed Problems:

  • nasal obstruction (due to a deviated nasal septum or enlarged nasal concha)
  • hyperplastic soft palate, uvula (which ‚wears out’ in time) or palatal tonsils
  • oversized base of the tongue
  • desiccation of the mucous membranes of the nasal and throatal area
  • weak epiglottis

Snoring can get dangerous though, when prolonged pauses in breathing occur. These can stress the cardio-vascular-system and, depending on their severity, shorten your life to up to 7 years!

We offer a home sleep apnoea test to screen our patients effectivly and in comfort for any form of obstructive sleep apnoea. You will receive a slim device (MicroMesam), which is about as big as the palm of your hand to take home with you overnight. Before you go to bed, you attach a thin sensor under your nose in order to register the airflow of your breathing. The results can be evaluated on our PC in the morning. In addition you will receive a questionnaire concerning your need for sleep and your sleeping behaviour throughout the day. We suggest answering the questions with your partner.

 

If the results are suspicious an OSAS (= obstructive sleep-related breathing disorder) is diagnosed, making further diagnostic measures such as an in-lab sleep study necessary.
If the results are inconspicuous we recommend an endoscopic analysis of the upper airways prior suggesting any specified treatment.

Prior to treatment, esp. when considering surgery, it is important to specify where exactly the snoring originates. Therefore, we recommend an upper airway endoscopy during a propofol-induced sleep or slumber (propofol-somnoendoscopy) for out-patients.

We arrange a set appointment at our surgery. Please, refrain from eating, drinking or smoking 6 hours before endoscopy. After placing a venous catheter into the crook of your arm, our experienced anaesthesist injects a well-tolerated anaesthetic (propofol. This induces an artificial sleep (with pleasent dreams) which leads to the snoring. We then insert a thin and flexible endoscope through your nose and can examine the complete oropharyngolaryneal area in order to determine the exact origin of the snoring. This examination is painless, safe and will be recorded on video.

We will demonstrate the results to you at our surgery within the following few days and discuss any further measures with you.

As mentioned above, weight loss is usually very helpful. Your general practitioner is sure to support you in finding the the right method.

 

The so-called sleep hygiene coonsists of a variety of different steps you are advised to take in oder to attain a good night’s sleep.For further information you can enqire at out surgery in Riehl, at the chemist’s or on the internet.

 

If we should discover a severely dry nose during our ENT-examination, we recommend the application of a custom-made nasal ointment every night.

 

Depending on the effectiveness of the above mentioned and on the results of the upper airways endoscopy, we offer the following forms of treatment:

  • Monobloc Snoreguard:
    The snoreguard is an individually fitted silicone tray which pushes the lower jaw about 5mm foreward, providing more room in the tongue base area. It takes about 20 minutes to customize. The snoreguard is placed inside the mouth before going to sleep. You get used to wearing it thoughhout the night after an acclimatisation period of about 4 to 7 days.

  • RLV-Vest:
    A lot of patients only snore/ pause their breathing when lying on their backs. This problem can be solved by wearing the so-called RLV-vest, which lets you roll onto your side automatically. This promotes regular breathing and improves day time well-being. Therefore, the vest is an inexpensive, but effective medicinal product for the treatment of obstructive sleeping apnoea and habitual snoring.

  • Alaxo-Stent:
    The Alaxo-Stent is a tubular, soft braid made of the so-called shape memory metal which acts like a rail guide to nose and throat. It is effective in the treatment of obstructive sleep apnoea (OSA) and snoring as it inhibits any kind of obstruction. It is worn over night and removed by the patient himself in the morning.
    Alaxo-Stent reduces the amount of obstructive apnoeas just as effectively as the CPAP-therapy. Cases of hypopnoea were significantly improved or completely healed.

Based on the degree of anatomical deviation, we may recommend one of the following forms of out-patient surgery:

  • Nasal Obstruction:
    Sometimes snoring problems result from a nasal obstruction of the airways. In these cases, it can be advisable to correct a nasal septum deviation and/ or to reduce the nasal concha. This method improves the nasal breathing and a dry throat immensely. However, the actual snoring is only reduced by about 30-40%.

  • Soft Palate or Uvula Obstruction:
    We usually perform the curtailment of an hyperplastic or elongated uvula and the reduction of a thickened palatal arch as out-patient or in-patiently surgery employing laser surgery or the extremely gentle radio frequency technology. Thus, we obtain more room in the throat area and the shortened structures are less prone to vibration.

  • Tongue Base or Laryngeal Obstruction:
    Laser reduction of the tongue base or tongue bone shifting are rarely indicated and require hospitalisation. We will gladly refer you to competent clinics if necessary.

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info@koeln-hno.de

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