By SUE MAYFIELD GEIGER
Correspondent
If you live with a snorer, a silent night this holiday season may be hard to come by.
Although often joked about, snoring is serious business, sometimes disrupting the sleep of entire families and forcing some couples to retire to separate rooms.
And sawing logs also comes with some serious health risks.
Snoring, which according to some polls affects 90 million Americans ages 18 and older — often is a symptom of sleep apnea, a disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.
The National Heart Lung and Blood Institute cautions that undetected sleep apnea can increase the risk of high blood pressure, heart attack, stroke, obesity and diabetes. It can also increase the risk of, or worsen, heart failure, and encourage irregular heartbeats.
Not all snoring, however, is related to sleep apnea, which can only be diagnosed by a physician.
Getting a physical exam is an important first step to a better night’s sleep, said Dr. Farrah Siddiqui of the University of Texas Medical Branch’s Department of Otolaryngology. Siddiqui also recommends getting a sleep study if merited.
There are several different ways to treat snoring, depending on the cause.
Studies show from up to two-thirds of snoring cases are associated with some degree of sleep apnea — more common in overweight patients and also in children who snore.
“If the sleep study shows evidence of sleep apnea, then a CPAP (Continuous Positive Airway Pressure) trial is important along with controlling other exacerbating factors,” Siddiqui said.
A CPAP is a treatment that uses mild air pressure to keep your airways open. In some cases, surgery may be the appropriate intervention, she said.
“Unless there is definite anatomical obstruction, CPAP is the most effective therapy for obstructive sleep apnea in adults,” said Siddiqui who cautioned that not all adults tolerate CPAP, in which case surgical intervention is recommended.
‘Quieter in their home’
The Pillar procedure has gotten more attention in the past five years and has been successful in treating snoring, experts say.
The Pillar procedure involves the placement of five woven inserts into the soft palate. Over time, the body’s natural tissue response to the inserts increases the structural integrity of the soft palate, thereby reducing the vibration that causes snoring.
More than 40,000 people worldwide have been treated with the Pillar procedure to reduce snoring, said Dr. Paul Fulmer, a medical branch graduate and medical director of The Snoring Center Houston.
Fulmer said he has seen a success rate (defined as bed partner satisfaction) of 85 percent to 90 percent, with the procedure.
Fulmer agrees that CPAP is the most effective treatment for patients with sleep apnea. But only 45 percent of patients who are given CPAP and advised to use it for their health can tolerate it, he said.
“So that leaves 55 percent of patients with sleep apnea and they are doing nothing,” Fulmer said. “Also, as much as 40 percent of the population snores and 25 percent are habitual snorers. These people don’t have sleep apnea, so they don’t need CPAP, yet they are still causing significant disturbance in their household. For these people, a procedure as simple and painless as the Pillar procedure makes perfect sense and gets them sleeping better and quieter in their home.”
Home sleep study
“Because the Pillar procedure actually places a permanent stitch under the lining of the soft palate, the result is permanent,” Fulmer said. “We often use the palate coblation as a “touch-up” for those patients who have had the Pillar procedure and are not completely satisfied. If they have other areas of their palate which need to be stiffened, then this is a perfect solution to get them quieter.”
The Sleep Center does offer a home sleep study, which Fulmer advises is a much more economical option for evaluating someone who is thought to have sleep apnea.
“They are able to take the study in the comfort of their own bed and get a true reading of how they sleep in their own environment,” Fulmer said. “It is also about a fourth of the cost of a traditional “in-lab” sleep study and gives us all the information we need to decide if a patient has sleep apnea, how severe it is, and if CPAP is an option.”
Lifestyle changes
A large number of sleep apnea cases in adults is preventable,” Siddiqui said.
“Obesity is the most important factor,” she said. “Better lifestyle with improved diet and exercise are the key to managing this subset of patients in the long run.”
And snoring isn’t just an adult problem.
“A lot of children with attention deficit disorder may in fact have sleep apnea,” Siddiqui said. “And parents may witness loud snoring, mouth breathing, restless sleep and even gasping.”
Some cases can be improved by tonsillectomy and adenoidectomy, she said.
Lifestyle intervention, including healthy diet and ample physical activity is imperative in the pediatric population, she said.
Helpful hints
- Sleep on your side. Lying on your back makes the base of your tongue collapse to the back wall of your throat. Try taping a tennis ball to the back of your pajamas to keep you from rolling over on your back. Elevate your head with an extra pillow.
- Lessen your alcohol intake. Alcohol and sedatives relax the throat.
- Lose weight. Excess weight causes fat to accumulate around your neck, squeezing the internal diameter of the throat, making it more likely to collapse during sleep.
- Quit smoking. Smoking aggravates the throat tissues and causes them to vibrate more.
Holistic remedies
Homeopathic throat and nasal sprays, neti pots and aromatherapy are natural remedies that enthusiasts swear by. Marjoram oil is believed to be the most appropriate, but a blend of essential oils can also work.
Over-the-counter products
- Nasal strips: Bands of plastic embedded in an adhesive pad keep your nose open, making breathing easier.
- Nasal support devices: Adjustable devices that fit in the nose. Also, consider nose clips that clip on the septum.
- Anti-snoring mouthpiece: A device that fits in your mouth that pushes your jaw forward while you sleep.
- Anti-snoring pillow: Supports and positions the head and neck to improve alignment, causing the throat to open the airway passage.
Where to get help
The Snoring Center
Dr. Craig Schwimmer Dr. Paul Fulmer 3900 Essex Lane, Suite 215, Houston 713-622-2345
View article on The Daily News – Coast – Heath & fitness Section (p.32)
