• Snoring, Sleep Apnea and Minimally Invasive Nasal Surgery

    Otolaryngologist John H. Romanow, MD, examines a patient to explore possible underlying causes of snoring and obstructive sleep apnea (OSA)At Lahey Hospital & Medical Center, we take a multidisciplinary approach to the evaluation of sleep disorders. The departments of Otolaryngology, Pulmonary Medicine and Neurology participate to diagnose and treat all types of sleep disorders. Although sleep apnea is the most common sleep disorder, the multidisciplinary nature of the sleep clinic allows the treatment of less common sleep problems, such as chronic insomnias, narcolepsy and sleep movement disorders. Frequently, the evaluation will be supplemented with a sleep test through Lahey Hospital & Medical Center's fully accredited sleep lab. This will assist in making a diagnosis, so that the correct therapy can be initiated.

    Habitual snoring affects up to 20 percent of the population. Thirty percent of patients who snore have obstructive sleep apnea (OSA). Snoring and OSA are part of a continuum of the same disease. The problem consists of either partial or complete airway obstruction during sleep. The difference between the two is important: OSA is clearly correlated with medical illnesses, such as heart problems and an increased risk of sudden death, while snoring is not. As such, snoring is considered a social problem (although sometimes it may have significant consequences at home!). A sleep test may be necessary to differentiate between snoring and OSA.

    An otolaryngology evaluation is essential to evaluate snoring and OSA. A careful examination of the upper airway is performed both to try to determine the site of airway collapse and to make sure that there are no other medical problems that might be causing the sleep disturbance. Possible sites of obstructions include the nose, tonsils, soft palate and uvula, tongue and voice box. Treatments, including minimally invasive nasal surgery, will differ depending on the severity of the problem and the results of the exam.

    Lahey Hospital & Medical Center also has a Sleep Disorders Center, combining specialists from the departments of Otolaryngology, Pulmonary Medicine and Neurology. Please visit this site for more information on sleep disorders, their causes, and the diagnostic and treatment options available.
     

    Treatment Options for Snoring

    Treatment options for snoring include the following:

    • Weight loss
    • Avoidance of alcohol and certain medications that may worsen snoring
    • Obtaining adequate sleep, so that an individual is not overly sleepy, which can worsen snoring
    • Specially made earplugs for the bed partner
    • Dental mouthpieces
    • Nasal surgeries
    • Minimally invasive outpatient procedures performed in the clinic to stiffen the soft palate and decrease its flutter and noise. These procedures include injection snoreplasty, PillarTM implants, radiofrequency treatment to the soft palate (Somnus) and laser-assisted uvulopalatopharyngoplasty (LAUP). At Lahey Hospital & Medical Center, we perform all of these procedures, and your consultation would include a discussion of which would be best for you.


    Treatment Options for Sleep Apnea

    Treatment options for obstructive sleep apnea include the following:

    • Weight loss
    • Avoidance of alcohol and certain medications that may worsen sleep apnea
    • Continuous positive airway pressures (CPAP), in which an appliance forces air through the nose and acts as a stent to keep the airway open at night. This is a very successful treatment for obstructive sleep apnea and is usually tried before other therapies. However, some patients do not tolerate the mask and seek other options.
    • Dental mouthpieces (usually for mild sleep apnea problems)
    • Minimally invasive surgery that may include operations on the nose, soft palate and uvula, tongue and neck. These operations are directed at the possible sites of obstruction in an effort to do the minimal surgery necessary to correct the sleep problem. These types of surgery would be discussed with you at the time of consultation and specific recommendations would be made.


    For More Information

    The Otolaryngology Department at Lahey has an active interest in research and state-of-the-art medicine, which allows us to offer a variety of new and innovative techniques for the treatment of sleep apnea and chronic sinusitis. These newer techniques are minimally invasive and often can be performed in an outpatient clinic or day surgery setting with significantly less discomfort than traditional approaches. These techniques may not be appropriate for everyone. If you are interested in making an appointment, please call 781-744-8467.
     

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