Snoring is a sound, emerging when there is stenosis on the air way. 45% of adults are sometimes, 25% are always snoring. In addition to the fact that the snoring is more in men and fat people than others, it can happen to everyone. With increasing age, the snoring also grows.
Why do we snore?
The tongue base, uvula, soft palate, the area that the tonsils are combined with the pharynx can be narrowed on its own. As a result of the relaxation of the muscles during sleep in this area, the air way is narrowed and the passing air causes the snoring by creating a trembling in soft tissues. The very first reason of snoring is the cervical tissue with the thick layer of fat in fat people, and tonsil and adenoid in children. People with nasal obstruction create a vacuum in nozzle throat in order to breath. As a result of the vacuum the soft tissues of the throat drawn towards the air way, as this snoring occurs in people even if they have never snored with open nose. Deformities causing the nasal obstruction, growth of nasal flesh, polyps, Having a long and sagging soft palate and uvula may cause us to snore. Alcohol and sedative drugs increase muscle relaxation and thus it increases snoring.
Why do men snore more?
The reason for this is that obesity in women is accumulated mostly in tight region but in men it is accumulated on neck and stomach areas. Especially, in overweight men this situation presses the diaphragm during the sleep (While sleeping on ones back ) and when the stomach is full and as a result of this pressure on the chest increases, conditions generating snoring occur with the middle tongue going back to the back and with the relaxation of the soft tissues and muscles of the pharynx. As the womens muscled structure becomes similar with those of the men after the menopause as the result of hormonal changes, and as they have neck type obesity, snoring also increases in them after some years.
Is snoring a problem?
If it does not create respiratory problems, then it is called simple snoring. If the snoring does not impose any suspension of breathing then it was thought that it did not give any damage to the patient. However, according to research carried out in recent years, even if there is not any suspension of breathing in sleep, power spent on breathing caused the tiredness, daytime fatigue and sleepiness. Concern of surroundings, especially my wife due to the sound creates problems. It can either be in the situation that may concern everybody. Snoring person faces several problems. Snoring person can face several problems. In some snoring people high pressure is higher than the others.
Can snoring be treated?
Many types are being treated. The followings are recommended:
Not take the drugs such as opiate pills, tranquilizer and antihistamine before sleeping.
Overweight is one of the basic reasons of snoring. It was determined that with the loss of weight snoring has remarkably decreased or completely disappeared in 80 % of patients.
What is the Obstructive Sleep Apnea Syndrome (OSAS)?
"Apnea" means to stop breathing. ASAS is a serious disease not going together with the beginning of sleep, but lasting with the discharge of the soft tissues and creation of air path due to the negative pressure formed during the breathing and as the result of this air entrance into the mouth and the nose stops for 10 seconds and the body makes additional effort for the respiration. Interruption of breathing is often repeated during the night (sometimes 100 times) and takes approximately 20-40 seconds. In cases when the situation is more serious, this time can be more than 2 minutes. During the interruption of breathing the amount of oxygen in the blood decreases, enough oxygen cannot be transported to heart, brain and other vital organs.
As the respiratory problems are observed during the sleep, the patient cannot feel this. This can be determined by the patients entourage. The main symptom is snoring. The majority of patients have severe snoring. While normally snoring, the sound is suddenly cut. The abdomen and chest continues moving during the interruption of breathing. That is why, the observing person cannot understand the interruption of breathing at first sight. To prevent this blockage diaphragm is flushed more than ever and the frequency of abdominal and thoracic procedures increases. The first and basic symptom of disease is daytime sleepiness. The other symptoms include waking up in the morning with dry mouth, headaches, intolerance, and carelessness. In children, setbacks in the lessons, frequent urination at night, night sweating regardless of the climate.
How is the diagnosis put?
It is put with the help of sleep test. Changes are noted during the night in the patient sleeping connected to polysomnography. The treatment plan is selected according to the complaints of the patient, results of sleeping test and the signs of the examination. Patients with heavy condition, who cannot be operated for any reason, use a mouth-nose mask positive pressure called CPAP (Continuous Positive Airway Pressure) or BPAP (Bi-level Positive Airway Pressure).
1. Surgery associated with the soft palate
The main purpose in this surgery is to increase the airway volume in the back of uvula and soft palate and decrease the sediment in tissues. ¼ of the patients have problems in this part. In half of the patients, the problem is in the root of the tongue or in the nose. In summary, it is observed that 75% of the patients have more or less soft palate or uvula problem. And the type of the surgery connected with the soft palate is changed according to the severity of the problem and the cause of airway blockage. While deciding the intervention, uvula, soft palate, back side walls of throat and tonsils should be checked together with the sleeping test.
a) Radiofrequency application on the palate
Radiofrequency is based on the principle of shrinkage and hardening in the tissues on mucous membrane with the energy given to the inside of soft palate. It is done with local anesthesia.
b) Shortening of uvula (uvulectomy)
The main function of uvula is to direct the food into the esophagus during absorption, to prevent food to go to the nose and throat, and simplify the passage of secretion coming from the nose and throat to the gullet. During severe snoring uvula is swollen by getting longer and thicker. The reason of snoring in some of the patients is this. Shortening of uvula is conducted in specially chosen patients.
c) Uvulopalatopharingoplastics (UPPP)
Among the most commonly performed operations in the soft palate surgery.
The principle of the surgery is to reduce the volume created by uvula, soft palate and tonsils and widen the air way in the back of soft palate. Soft palate surgery is generally observed to be successful in 85% of simply snoring patients and 25-75% of patients with apnea syndrome. After the UPPP surgery complications, such as the passage of foods to the respiratory tract (velopharyngal insufficiency), bleeding, infection, postnasal discharge, and difficulty in swallowing, breach of taste are observed. And the most common complaint is pain after surgery. Pain happens within the first 5-7 days.
2. Tongue base and related surgery.
One region causing problems in these patients is the back of the tongue. Especially, patients who already have high weight and body mass index_en reduce complaint when losing weight that is why before the surgery these patients are recommended to lose weight. There are various surgical operations carried out for the tongue base.
Application of radiofrequency to the tongue base
Reduction is observed in the volume of tongue base when applying radiofrequency. This surgery can be combined within the same session together with other surgery.
3. Nose surgery
Every patient coming with snoring and apnea complaint should be examined. Some patients have problems such as curve of the nose or growth of nasal fleck. According to the size of the problem, relevant treatment method is chosen.