Type of Surgery
Information

Last updated: 11/24/2009
Oral devices and appliances
Oral appliances are intended to reduce snoring by changing the shape of the oral cavity or preventing the tongue from blocking the airway. There are three basic types of mouthpieces: those that push the lower...
jaw forward; those that raise the soft palate; and those that restrain the tongue from falling backward during sleep. To work properly, oral appliances should be fitted by an experienced dentist or orthodontist and checked periodically for proper fit. Their major drawback is a low rate of patient compliance; one German study found that only 30% of patients fitted with these devices were still using them after four years. In addition, oral appliances cannot be used by patients with gum disease, dental implants, or teeth that are otherwise in poor condition.
Continuous positive airway pressure (CPAP) devices
CPAP devices are masks that fit over the nose during sleep and deliver air into the airway under enough pressure to keep the airway open. If used correctly, CPAP devices can be an effective alternative to surgery. Their main drawback is a relatively low rate of patient compliance; the mask must be used every night, and some people feel mildly claustrophobic when using it. In addition, patients are often asked to lose weight or stop smoking while using CPAP, which are lifestyle adjustments that some would rather not make.
Lifestyle changes
Patients who snore only occasionally or who are light snorers may be helped by one or more of the following changes without undergoing surgery:
- Losing weight and getting adequate physical exercise.
- Avoiding tranquilizers, sleeping pills, antihistamines, or alcoholic beverages before bedtime.
- Quitting smoking.
- Sleeping on the side rather than the back. One do-it-yourself device that is sometimes recommended to
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keep the patient turned on his or her side is a tennis ball placed inside a sock and attached to the back of the pajamas or nightgown. This approach seems to work for some patients with simple snoring. - Tilting the head of the bed upward about 4 in (10 cm).
Complementary and alternative (CAM) approaches
There are three forms of alternative treatment that have been shown to be helpful in reducing primary snoring in patients with histories of nasal congestion or swollen tissues in the throat. The first is acupuncture. Treatments for snoring usually focus on acupuncture points on the stomach, arms, and legs associated with the production of excess mucus. Insertion of the acupuncture needles at these points is thought to stimulate the body to release the excess moisture or phlegm.
Homeopathy and aromatherapy also appear to benefit some patients whose snoring is related to colds, allergies, or sore throats. Homeopathic remedies for snoring are available as nose drops and throat sprays as well as the traditional pill formulations. Aromatherapy formulas for snoring typically contain marjoram oil, which may be used alone or combined with lavender and other herbs that clear the nasal passages. Some people find aromatherapy preparations helpful alongside mainstream treatments because their fragrance is pleasant and relaxing.
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Other Information
Surgery is also available as a method of correcting 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, however, 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 velopharynx. Scarring is an individual trait, so it is difficult for a surgeon to predict how much a person might be predisposed to scarring. Some patients have reported the development of severe sleep apnea as a result of damage to their airway caused by pharnygeal surgery. Currently, 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.
Bipolar radiofrequency ablation, a technique used for coblation tonsillectomy, is also used for the treatment of snoring.
Other Information
In 2006, estimates of the direct medical costs of allergic rhinitis in the US ranged from $1.16 billion to $4.5 billion, rising to $7.7 billion when indirect costs were included.
From: AHRQ
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