Snoring Super Speciality Clinic

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Snoring Super Speciality Clinic

Appropriate corrective measures of snoring for each individual. However, surgery isn’t suitable or necessary for everyone who snores. Advanced Radio Frequency Treatment, snoring treatment without surgical incisions is now available at MicroCare ENT Hospital, Hyderabad, India

Your Snoring Could be a Thing of the Past

Thanks to a New Radio Frequency at MicroCare ENT Hospital to Stop Snoring and Blocked Nose.

  • End your snoring in just few minutes
  • An affordable and gentler procedure
  • No cuts, No stitches, No downtime
  • Procedure performed by Dr. Vinnakota Sriprakash MS ENT at MicroCare ENT Hospital Research Institute, an international super speciality ENT Hospital, Hyderabad, India.

MicroCare ENT Hospital Offers the best Snoring Treatment in Hyderabad by Top snoring hospital in hyderabad.

Snoring

Definition of Snoring:

Snoring is a noise generated from the upper airway (throat, tongue and roof of the mouth) due to partial upper airway obstruction. Snoring occurs when air flows past relaxed tissues in your throat, causing the tissues to vibrate as you breathe causing the classic snoring noise. The more the airway is blocked, the louder and more persistent the snoring becomes.

Snoring is Often Associated With Sleep apnoea (OSAS), a potentially life threatening condition either directly because of long term cardiac effects or indirectly because of excessive day time sleepiness leading to road traffic accidents and it can disrupt your household. OSAS is a condition that may well not be cured by surgery alone but for which there are successful alternate treatments.

Causes and Mechanism of Snoring

It is not fully understood why people snore or develop upper airway obstruction. Research at MicroCare ENT Hospital and at various ENT hospitals all over world revealed Male sex, increasing age and obesity are well recognized associations. Snoring and OSAS are exacerbated by alcohol and sedative medications.

A variety of factors contribute to snoring, including:

  • Poor muscle tone (after alcohol or sedative use)
  • Enlarged tonsils and adenoids
  • A long soft palate or uvula
  • Nasal problems
  • Blocked nasal airways from polyps, a deviated septum, allergies or a cold
  • Excessive weight causing tissue at the neck to be bulky and flaccid
  • Tissue swelling from cigarette smoking
  • Hypothyroidism.

Alcohol consumption: Snoring can also be brought on by consuming too much alcohol before bedtime. Alcohol relaxes throat muscles and decreases your natural defences against airway obstruction.

Association with Obesity: Up to 70% of the people having OSAS are obese. Obesity leads to fat deposition around muscles in the neck which in turn causes small airway. The more obese the person the more likely it is that he will have OSAS Sleep apnoea.

Complications of Snoring

Snoring and OSAS may raise your lifetime risk of developing health problems like high blood pressure, heart failure and stroke. In children, obstructive sleep apnoea may increase the risk of Attention-Deficit/Hyperactivity Disorder (ADHD).

Effects on Heart:

Heart has to work hard to pump against high negative intrathoracic pressures and increased lung and peripheral arterial resistance. Heart enlarges during an obstructive episode. This excessive workload to continue throughout the night is extremely abnormal and results in most serious consequences of untreated OSAS i.e. heart problems. This is the reason why it is so important to exclude or establish the diagnosis of OSAS.

Social consequences of Snoring and OSAS:

Excessive day time sleepiness can vary from a feeling of being generally tired to actually falling asleep during important activities. Patients are often not good at assessing their degree of daytime sleepiness and talking to the partner may give a more accurate picture of the degree of the problem.

Daytime sleepiness and disturbed sleep are responsible for other psychological and intellectual changes that those with OSAS may exhibit. These include personality change, poor memory and difficulty in concentrating. These complications combines with loud snoring can result in serious social consequences. Example include marital stress, partners sleeping in separate rooms sometimes leading to divorce, interference with the performance of the job possibly leading to loss of employment and unwillingness to stay in hotels often limiting business and leisure pursuits. Even people sleeping nearby rooms can lose excessive amounts of sleep and this often leads to resentment .

Increased incidence of Road Traffic Accidents:

Far more serious is the increased incidence of accidents, especially road traffic accidents because of day time sleepiness and poor concentration.

Tests and diagnosis of Snoring

To assess patients’ general condition:

  • Weight
  • Height
  • Blood pressure
  • FBC look for polycythemia/ anemia/ MCV (? Alcohol)
  • TFT
  • CXR- to detect heart enlargement or lung disorders
  • ECG- to detect heart disease
  • Blood Gases- arterial Po2 and Pco2
  • Lung Function Tests.

To differentiate between simple snoring and OSAS:

1) Polysomnography- the gold standard investigation in the diagnosis of OSAS. It involves spending a night or more in a sleep laboratory connected to a variety of monitors.

2) Overnight pulse oximetry recording- this is much cheaper and simpler than full Polysomnography and is often used as alternative screening test.

To assess site of obstruction in awake patients:

  • Evaluation by Video Nasal endoscopy and Direct Endo Laryngoscopy
  • Nasendoscopy while patient is performing Reverse Valsalva (Miller’s Manoeuvre.
  • Lateral Cephalometry- lateral Head and Neck X- ray
  • CT scan
  • Sleeping patients
  • To assess site of obstruction in Sleeping patients:
  • Sleep Nasendoscopy
  • When to seek medical advice

MicroCare ENT Hospital and Research institute strongly advocates:

You may not be aware that you snore, but your bed partner likely is. Seeing your ENT doctor about your snoring can help both you and your partner.

For you, snoring may indicate another health concern, such as obstructive sleep apnoea, nasal obstruction or obesity.

For your partner, your seeking ENT advice about your snoring may result in being able to get a restful sleep.

If your child snores, ask your ENT Doctor about it. Children, too, can have obstructive sleep apnoea, though most don’t. Nose and throat problems, such as enlarged tonsils, and obesity often underlie habitual snoring in children. Treating these conditions could help your child sleep better.

MicroCare ENT Hospital has top snoring doctors in Hyderabad

Sleep Apnoea

Obstructive Sleep Apnoea Syndrome, OSAS:

Snoring may also be associated with obstructive sleep apnoea. In this serious condition, your throat tissues obstruct your airway, preventing you from breathing.

Sleep apnoea is often characterized by loud snoring followed by periods of silence that can last 10 seconds or more. Sometimes, complete obstruction does not occur, but rather, while still snoring, the airway becomes so small that the airflow is inadequate for your needs. Eventually, the lack of oxygen and an increase in carbon dioxide signal you to wake up, forcing your airway open with a loud snort or gasping sound. This pattern may be repeated many times during the night.

Any space occupying lesion from nose orifice to vocal cords can predispose to obstructive sleep apnoea.

Clinical features and complications associated with the snoring and OSAS essentially result from the two main effects of the obstructive episodes.

1. Oxygen desaturation

2.The generation of high negative intrathoracic pressures.

Arousals: Recent studies suggest that the main factor producing arousal is the high level of negative intrathoracic pressure generated by increased respiratory effort associated with the airway obstruction. When the degree of respiratory effort reaches a certain threshold, arousal occurs, resulting in a return of tone to the upper respiratory muscles and the obstruction clears.

The patient is often unaware of these arousals which can occur many hundreds of times throughout the night. The effect of repeated arousals is a very disturbed sleep pattern which is reflected in the excessive day time sleepiness.

In OSAS, the bed partner will describe periods of very loud snoring interspersed with periods of silence during episodes. These episodes usually last 20-60 seconds but can last up to a couple of minutes, though most partners will not usually wait this long and will rouse the patient. The snoring then resumes before next episode begins.

The minimum criteria for diagnosis of OSAS are more than 5 episodes per hour.

Treatments for Snoring

Non- Surgical Treatments:

Drugs play no part in treatment of Snoring.

Non- Surgical Treatments for Snoring available at our Snoring Clinic, MicroCare ENT Hospital and Research institute are

CPAP for OSAS

Nasal Continuous Positive Airway Pressure (CPAP) – this is the gold standard treatment for OSAS. It is effective in 99% patients who can tolerate. This approach involves wearing a pressurized mask over your nose while you sleep. The mask is attached to a small pump that forces air through your airway, which keeps it open. CPAP eliminates snoring and prevents sleep apnoea.

Although CPAP is the preferred method of treating obstructive sleep apnoea, some people find it uncomfortable Nasal BiPAP (bi level positive airway pressure)

Surgical Treatments:

  • Radio Frequency Treatment
  • Radio surgically assisted UP3

Radio Frequency Treatment: Treatment without Surgery – This simple technique using Radio Frequency removes excess tissue without surgical incisions.

Radio Frequency Treatment – LATEST ADVANCEMENT IN THE SNORING SURGERY at Microcare ENT Hospital

700% less lateral damage than Laser

A) Radiosurgically Assisted Uvulopalatopharyngoplasty UP3

B) Radio Frequency Treatment (Somnoplasty) Treatment without Surgery

Radio Surgical Volumetric Reduction of Redundant Tissue of Soft Palate and Tongue Base.

  • Done in OP, can go back home immediately
  • No hospital stay
  • Non-invasive procedure
  • No surgical incisions
  • Less post-operative pain
  • Faster Healing
  • Cost effective

Indications: Obstructive Sleep Apnoea, Chronic Nasal Obstruction and Habitual Snoring.

Radiofrequency energy generate heat at temperatures between 65 C (149 F) and 95 C (203 F) for creating pinpoint coagulation at precise locations within the upper airway. Normal cells and tissues are not destroyed. The generated heat directly denatures protein structures, and as the tissue heals in approximately three to eight weeks, the tissue volume is reduced; opening the airway. That result in gradual decrease in snoring in a month or so and for most people the problem is resolved.

Depending on the severity of snoring a second procedure is required after 6-8 weeks. The success rate in this method of treatment is 80- 90%.

Coblation Technology Assisted Palatoplasty:

Coblation technology: an innovative science for medical applications

Coblation technology uses electrical energy to excite the electrolytes in a conductive medium like saline, creating precisely focused plasma. The energized plasma particles possess sufficient energy to break organic molecular bonds, resulting in tissue dissection and ablation.

The unique properties of Coblation technology enable rapid and controlled removal of tissue while preserving the integrity of surrounding healthy tissue as the radiofrequency current does not pass directly through the tissue, relatively low temperatures (40°C to 70°C) are generated as a by-product of the process.

No Potential Side Effects:

No hazardous side effects are observed with Coblation Palatoplasty. It is a safe and minimally invasive technique.

Laser surgery

Successive vaporizations of lax tissue thus removing excess tissue enlarging your airway and reducing the vibration of snoring in the palate are performed under local anaesthesia in the outpatient ENT clinic. The patient response determines the no. sessions.

Laser surgery generally is not recommended for sleep apnoea.

Palatoplasty

Palatoplasty or Uvulopalatopharyngoplasty (UP3): This operation essentially involves removing the tonsils, trimming the faucial pillars if required, removing the uvula and a variable amount of soft palate. You will be given General anaesthesia during this procedure.

This results in removal of excessive and space occupying tissue with corresponding increase in the cross sectional area of upper airway. It is a type of face- lift to your throat.

Indications for UP3 are

1. Socially disruptive simple snoring
2. OSAS where obstruction is primarily at the upper oropharyngeal level.

Pillar Implants:

Pillar implants are tiny implants inserted into the soft palate to reduce the tissue vibrations that cause snoring.
This procedure is a simple, safe and effective treatment designed to help you stop snoring in selected patients suffering from mild to moderate obstructive sleep apnoea (OSA).

The Pillar Procedure stiffens the soft palate, which is believed to be a significant contributor for at least 80% of people with snoring. This can be performed in about 20 minutes.

The Pillar Procedure has only limited benefits for most patients with moderate to severe obstructive sleep apnoea.

  • Tonsillectomy
  • See Tonsillectomy
  • Adenoidectomy
  • See Adenoidectomy
  • Turbinate reduction

Turbinate Reduction is a quick, painless office based procedure that can provide effective relief from nasal congestion or blockage.

The Coblation wand emits radio frequency energy that shrinks the turbinates in a minimally invasive procedure.

Benefits of Turbinate Reduction:

The turbinates are structures inside the nose. Enlarged turbinates can cause nasal block and difficulty in breathing. Turbinate Reduction shrinks the turbinates providing relief from nasal allergy symptoms.

Turbinate Reduction can help:

  • Reduce sinus-related snoring
  • Relieve nasal congestion & drainage
  • Reduce the severity of severe or chronic nasal allergies
  • Improve breathing.

Septoplasty

Deviated Septum of the nose is a common condition that may lead to a blocked airway leading to snoring and sleep apnoea and can be treated with surgery called septoplasty.

What Is a Deviated Septum of the Nose?

A shift in the position of the midline nasal septum to left or right might disrupt the passage of breathing air. This blockage may be partial or complete one side or both sides.
This may occur approximately 80 percent of people from birth due to a genetic or congenital cause or may also occur as a result of trauma.

Septoplasty: Nasal surgery to fix a deviated septum of the nose

Septoplasty i.e. moving the nasal septum back to the midline to open up the airways on each side is done if breathing problems like snoring or sleep apnoea occur due to deviated septum.
This is often curative treatment for snoring if the snoring is caused by deviated septum of the nose.

Latest advancements in Snoring surgery

Snoring is caused by many factors in the upper air way from nostrils area to vocal cords area. There is no single treatment which cures the snoring as snoring is usually caused by several factorsin individual patients.

Snoring surgery is an ever changing field; many new techniques are being developed both in surgical methods and in modern equipment.

Life Style Changes

Lifestyle changes and home remedies advised by MicroCare ENT Hospital

To prevent or quiet snoring, try these tips:

If you’re overweight, lose weight: Being overweight is a common cause of snoring. Loose throat tissues are more likely to vibrate as you breathe, and extra bulkiness in the throat narrows your airway.

Sleep on your side: Lying on your back allows your tongue to fall backward into your throat, narrowing your airway and partially obstructing airflow. To prevent sleeping on your back, try sewing a tennis ball in the back of your pyjama top.

Treat nasal congestion or obstruction: Nasal strips. Adhesive strips applied to your nose help many people increase the area of their nasal passage, enhancing their breathing.. Having allergies or a deviated septum can limit airflow through your nose. This forces you to breathe through your mouth, increasing the likelihood of snoring. To correct a deviated septum, you may need surgery.

Limit or avoid alcohol and sedatives:

Avoid drinking alcoholic beverages at least four hours before bedtime, and let your doctor know about your snoring before taking sedatives or hypnotics.

Sedatives and hypnotics (sleeping pills) and alcohol depress your central nervous system, causing excessive relaxation of muscles, including the tissues in your throat. In addition, if you stop breathing due to obstructive sleep apnoea, it may take longer for you to begin breathing again because alcohol, sedatives and hypnotics blunt the brain’s ability to arouse from sleep.

FAQs

There are many different causes and each individual needs to be fully examined to find the reason for their snoring. Sometimes there are multiple causes, sometimes no obvious reason can be found.