Snoring is noisy and can drive a partner out of the bedroom. Sleep apnea is far more serious and can shorten your lifespan. These conditions are very prevalent in our patient population.
The common device known as continuous positive airway pressure (CPAP) or variation of this is frequently recommended for these patients. Sometimes the devices are successful and very helpful and other times they’re difficult to tolerate, for a number of various reasons. Patients frequently ask if there are options.
There are a number of choice is available depending on the severity of the problem. Oral appliances also known as oral appliance therapy can be a simple and effective way of controlling snoring and mild obstructive sleep apnea (OSA).
In rare cases, it can be used for moderate disease, but it is not generally recommended for severe.
Devices can be custom fitted or prefabricated. These items sometimes can be adjustable. Their goal is to reduce the upper airway from collapsing. Patients must have good oral health. This includes teeth in good condition and the patient should have a normal bite (closure) and not have problems with the jaw joint (TMJ).
Various forms of palate surgery are available. Starting with the simple excision of the uvula, which is the soft tissue that hangs in the midline from the soft palate. If it is large, elongated or both, it can be a problem.
Removal of soft palate tissue and advancement of the hard palate, which involves cutting of bone and teeth can be also utilized in some cases.
It is obviously more involved and there is more time needed for it to heal. It can ultimately affect your bite and your speech and swallowing.
In some instances, braces are even needed for a period of time. Tongue surgery is generally reserved for very serious situations as it carries a very high risk of intraoperative and postoperative complications.
As you can imagine, any surgery on the tongue could potentially affect taste speech and swallowing. Surgery involving the cartilaginous structure of the throat is also available. It runs the gamut of simple to complex depending on the severity of the condition and the need.
Adenotonsillectomy, better known as T&A or removal of adenoid and tonsil tissue, can be very effective in our pediatric patients and can be effective in adults, but is less likely and therefore not frequently utilized unless it’s in combination or conjunction with other procedures to enhance the airway.
Electronic stimulation of the muscles of the throat is also an option. The device is turned on at night and delivers electric energy to make the muscles of the throat rigid so they do not collapse so that snoring and apnea does not occur.
There are protocols and processes that are involved in making a decision about alternative methods besides CPAP. A patient’s age, health, weight and insurance coverage are common factors, as well as the severity of the apnea.
Denis W. Grillo, D.O., FOCOO, is an ear, nose and throat specialist in Crystal River. Call him at 352-795-0011 or visit CrystalCommunityENT.com.