An estimated 23 percent of American couples sleep apart, according to a survey by the National Sleep foundation. In many cases, partners are choosing separate beds because of their partners snoring.
For people who want to minimize disruption to their bed partner’s sleep or relieve themselves of any embarrassment caused by the snoring, let's discuss options for treatment.
Remember,
in my previous blog the first question to answer is whether or not your snoring is related to obstructive sleep apnea (OSA). The options discussed below may help with snoring whether related to OSA or not:
Lifestyle Changes
1) Weight loss: In obese patients who snore, weight loss improves snoring and improves OSA. Plain and simple.
2) Tobacco and alcohol: Current smoking is associated with snoring so smoking cessation is recommended to all patients who snore. Elimination of alcohol, especially during the hours prior to bedtime, will also improve snoring.
3) Sleep position: In many observational studies sleeping in the lateral position (on your side) has been shown to improve snoring.
Improving Nasal passages
1) Decongestants: Not every snorer should use these but if you have snoring during cold or allergy season an oral or topical decongestant will help your snoring.
2) Nasal steroid sprays (Flonase, Nasonex, Nasocort, etc): A trial of these is reasonable and has been shown to improve snoring in many who use it on a regular basis.
3) Nasal Surgery: Only in patients who have a deviated septum has surgery been shown to improve snoring.
Mechanical Devices
1) Oral appliances (OA) increase the size of the upper airway during sleep, which decreases snoring. OA are highly effective when used properly and should be fitted by dentists with expertise in sleep-related breathing problems.
2) CPAP (Continuous positive airway pressure): CPAP is an effective, safe, and reversible therapy even if the snoring is unrelated to obstructive sleep apnea (OSA). In patients with OSA, CPAP is the mainstay of treatment.
3) OA versus CPAP: Studies indicate that CPAP is more effective than oral appliances in treating OSA.
Surgical Approaches
These should be used as a last resort for patients who do not want to receive chronic mechanical therapy (either CPAP or OA) and who continue to snore despite the therapies listed above.
1) Uvulopalataopharyngoplasty (UPPP): This surgery removes tissue from the soft palate and tonsillar pillars. Some patients report feeling better after UPPP though sleep studies done on patients after this procedure do not show a change in snoring frequency or intensity.
2) Laser-assisted and Radiofrequency palate surgery: Both of these procedures do seem to result in improvement in snoring according to some small studies.
3) Palatal implants: This procedure involves inserting braided filaments into the soft palate. Some small studies have showed that patients and their bed partners report improvement in snoring.
If you snore and have tried these interventions, what has your experience been?
Dr O.