Snoring is a very disruptive and common problem. It is generally made by vibration of surfaces together in the upper airway. Most snoring noise emanates from the soft palate, and is louder when the mouth is open. Other sites contributing may be the back of the tongue and the nose, and sometimes structures in the lower throat. Between 30 and 40% of the population snores, and it seems to be more common in men. As one gets older, snoring frequency and loudness increase owing to the reducing levels of “elastin” in aging tissues. Weight gain, smoking, alcohol, sedatives, and back sleeping often worsen snoring. Some other factors are not easily solved such as small lower jaw, and some have large tonsils which may need to be removed to reduce the problem. Bad snorers can wake very tired, or have daytime sleepiness. Snoring has also been implicated as an aggravating factor in other medical problems such as hypertension and depression. Fixing snoring does not necessarily solve these problems.
Sleep Apnoea is the cessation of breathing for a variable length of time in sleep. This is caused by obstruction to the airway with the tongue, and results in falling oxygen levels. This is often associated with a number of health problems, and can be diagnosed with “Sleep Study”. This condition is often the source of most concern to the partner, and may occur in as many as 10% of adults.
Options for the snorer are quite varied, and really depend on where the snoring originates. This is determined by the examination of a doctor experienced in this field. Doctors trained in the “Snore-Op” method have had extra training in this examination and technique. Most people who present to the doctor have tried a range of treatments with limited success. Most methods have benefit for some patients and range from throat and nose sprays, nasal splints, jaw advancements splints, to minor and major surgical corrections.
The Snore-Op: The Radiofrequency Tissue Volume Reduction technique (eg “Snore-Op”) is amongst the most likely to succeed (around 80% of our patients have a reduction with one treatment, and a further 10% respond to a second treatment). It is a minor operation requiring only local anaesthesia, and done in the doctor’s office. It is very like a trip to the dentist, where local ™ anaesthetic is used to numb the palate, and two small areas of the soft palate are treated painlessly. The snoring gets worse for two or three nights, then lessens progressively over about 2 months. Most notice initial improvements from about 14 to 21 days postoperatively. The effectiveness and longevity of these results varies in individuals. A patient who reduces his snoring to less than “3” on the snoring scale below is likely to have a result lasting 3 to 5-plus years in our experience. Other treatment options will also “wear off” with increasing age and weight. It is a very simple matter to repeat this treatment, and it is very cost-effective. Much of this method was pioneered and developed by New Zealand doctors, and is now used world-wide.
In a survey of fifty patients, they were asked to rate the pain they felt after the anaesthetic wore off. They rated the pain on average 2/10, ranging from zero to four. Only a quarter of them felt they needed mild analgesia. However, some choose to take two panadeine prior to the operation to cover the possibility of pain when the local wears off ninety minutes later. Antiinflammatories and aspirin-like drugs are not recommended. People who have had the major surgical operations (UPPP and LAUP) can have a “Snore-Op” to re-tighten their palates. This has been very effective in certain cases.
The post-operative phase: It is recommended that cool fluids and ice are used to reduce inflammation the first evening. Difflam anti-inflammatory oral spray can be a help in some cases. Non-aspirin-like analgesics are recommended for the people who do wish to take tablets. The swelling that often occurs of the Uvula (dangling from the back of the palate) is reduced by sleeping on a slope of 30 to 45 degrees for one to three nights, and in worst cases, gargling with a strong salt solution. Eating and drinking present no major problems. Speech can be temporarily affected, lasting at the most two to three days.
You will be given a “Post-operative Trouble Shooting Sheet”, with the contact number of your doctor, should you need to call him after hours. Any fever or increasing pain should be notified to your doctor. Follow-up is recommended at between three and seven days, and another visit eight weeks post-operatively. A further treatment can be carried out at the eight week visit when the improvement reaches a plateau if there is insufficient response.
People with cardiac pacemakers should not have this procedure without consulting their cardiologist.
Snoring usually gets worse for a few nights, but this soon passes.
Very rarely, a patient has an allergy to the local anaesthetic. If you have not had a reaction to a dental injection, there should be no problem.
Also very rare is a perforation of the palate, which heals quickly and well. This is avoided by effecting burns mainly to the thickest part of the palate.
Those with heart valve disease, or artificial heart valves, or artificial joints should mention this in the pre-operative discussion with your operating doctor.
These present a minimal risk, but should be considered. Those who are known to have Hepatitis B or C, or those who may be HIV positive should also inform their doctor in confidence of their condition.
Some people may need a similar procedure with radiofrequency surgery performed on the turbinate tissues of the nose. This option will be assessed at the initial visit, and is usually not required. Turbinate surgery, which is usually totally painless after the local anaesthetic, is done when the blocked nose is considered part of the problem. Some might also require the uvula shortened where this is large and thought to be problematic. These minor operations can be carried out where necessary with the palate procedure.