Sleep Disorders

	Surgical Alternatives Somnoplasty UPPP Genioglossal/Hyoid Repositioning Procedure Injection Snoreplasty

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Snoring happens when air cannot flow freely through the passage in your throat. This results in rasps and rattles that can disrupt the sleep of those around you. But you may not know that snoring can also disrupt your own sleep and may even be a sign of a serious condition called sleep apnea. Snoring is a social problem; sleep apnea is a medical problem.

When a person has sleep apnea, the throat becomes blocked during the night, stopping breathing for short periods of time. If you have this condition, your partner may hear you alternate between snoring very loudly and being very quiet. You may even gasp or snort in your sleep. Other symptoms may include:

1.Waking up tired or with a headache
2.Feeling very sleepy or falling asleep at inappropriate times (eg. at work or while driving).
3. Irritability and a short temper.
4. Concentration and memory problems.

Snoring and sleep apnea rarely go away, but they can be treated. Certain recommendations given to you by your doctor may be of great help. He may suggest certain position changes while sleeping, eating a lighter, earlier evening meal, avoiding alcohol and considering weight loss, if indicated. Your doctor may also find certain problems on physical examination which may be helped either medically or surgically. Nasal congestion from allergies, deviated septum, or polyps may cause an obstructed breathing pattern. Large tonsils, an elongated uvula, flabby soft palatal tissues and an enlarged tongue or recessed jaw may contribute to the sleep disorder. After your doctor's examination, it will usually be necessary to perform a sleep study to determine just how severe your breathing disorder is.

A sleep laboratory may require that a night be spent in a private room inside a sleep center, or, if indicated, in the comfort of your own home. During this study, special sensors record the activity of your heart, lungs, brain, the movements of your muscles, airflows from your nose and mouth, and the level of oxygen in your blood. In addition, your body movements are videotaped and snoring, talking or other noises you make while asleep are recorded. If you have severe sleep apnea during the night, you may be provided with a CPAP (Continuous positive airway pressure) device that keeps your air passage open and helps you breathe.

After your sleep study, your doctor will see you to discuss the results and recommend the form of therapy for your problem. Often a CPAP device will be recommended, especially if you have moderate or severe sleep apnea. Other therapies that may be recommended include the use of certain oral devices, diet and exercise, medical therapies for nasal conditions, and surgical alternatives.

Surgical Alternatives

1. Somnoplasty
This procedure is helpful for snoring and mild sleep apnea. It is performed in the doctor's office, usually one or two treatments are needed until the desired effect is obtained, and can be done under local anesthesia, without significant discomfort to the patient. Somnoplasty is performed using radiofrequency energy applied to the soft palate, uvula, and/or tongue base. This creates zones of coagulation beneath the surface layers, thus reducing the obstruction caused by the previously swollen soft tissues.

Work with your doctor to get the most out of your treatment plan. Successful treatment of sleep-related breathing problems can help you and your partner get quiet, restful sleep and let you wake up feeling alert, refreshed, and ready to face the day.

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2. UPPP
Uvulopalatopharyngoplasty is the most common type of surgery for snoring and sleep apnea. This procedure involves removing the uvula, part of the soft palate, and the tonsils from the throat. It is often successful in stopping the throat structures from rattling and causing snoring. However, it is generally less successful in treating sleep apnea, because tissues farther back in the throat may still block the air passage.

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3. Genioglossal/Hyoid Repositioning Procedure
This procedure is especially helpful for those patients who have a large beefy tongue, who are of relatively normal weight, and tend to obstruct due to the tongue falling into the back of the throat. Specific tongue muscles and a small bone in the neck are repositioned surgically to achieve the desired airway improvement.

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4. Injection Snoreplasty
Another new procedure available for treatment of snoring is injection snorplasty. This involves injecting a solution into the soft tissues of the palate which then creates stiffening. This can be performed in the office under local anesthesia alone.

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