snoring

what causes snoring?

During sleep the muscles of the throat relax.
If they become too floppy these muscles and the throat lining vibrate as we breathe in and out. This vibration causes the noise of snoring. Snoring can result from any or all of the muscles of the throat not just from the soft palate at the back of the top of the mouth.

what is obstructive sleep apnoea syndrome (OSAS)?

If the throat becomes very floppy it collapses inwards and may block (obstruct) breathing so that airflow stops (apnoea). Snoring noise then stops. In seconds the brain detects that oxygen levels drop in the blood and the individual is roused from deep to light sleep. The muscles then recover enough strength to pull the throat open, with a loud snore, and oxygen levels in the blood return to normal. The individual then drifts into deep sleep again and the cycle repeats. In the morning and when severe through the day, the individual feels sleepy and unrefreshed as they have had multiple episodes of lost deep sleep throughout the night.

general measures

weight loss

avoiding alcohol after 7 o'clock in the evening

general measures

weight loss

avoiding alcohol after 7 o’clock in the evening

mandibular advancement splints

These are fitted by an orthodontist and are worn
like a gum shield over the top and bottom teeth. They pull the lower jaw (mandible) forward. This pulls the tongue forward creating more space in the throat and whilst worn also hold the upper throat muscles tight making them less likely to vibrate.

nasal surgery

Some patients who snore have a blocked nose. Surgery to improve nasal breathing may improve snoring.

soft palate surgery

The soft palate is at the back of the roof of the mouth and lifts when you say “ah”. The uvula hangs from it in the middle. In some patients the soft palate vibrates and is the cause of snoring. A range of operations can be performed to trim or stiffen the palate.

We use the somnoplasty technique. This is a local anaesthetic procedure. The palate is sprayed with local anaesthetic and then further local anaesthetic injections, the same as used by dentists, are given into the soft palate. A needle probe is then placed, usually into 3 areas of the soft palate, which are heated using radiofrequency wave energy. This causes stiffening of the palate. The procedure takes about half an hour and then patients can return to work. We feel this procedure is much less painful than laser to the palate.

tonsillectomy

In some adult patients but more often children,
very large tonsils may cause snoring.

what are the results of treatment for snoring?

It is not possible in all patients to be sure which muscles of the throat cause snoring and so it is
very difficult to decide which is the best treatment.
Most treatments help in about 50% of patients.

what is the treatment for obstructive sleep apnoea?

If we think you have OSAS then we will suggest a sleep study to assess your breathing overnight. If you have moderate or severe OSAS it is unlikely surgery will help and we advise continuous positive airway pressure (CPAP) therapy. This involves sleeping with a nose or face mask attached to a machine which provides air under pressure to keep your throat open. This prevents snoring and ensures a good, deep night’s sleep without daytime sleepiness.