Del Mar M.E.D.

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Snoring

What causes snoring? And how do you stop snoring?

Snoring is a noise made by the vibration of tissue in the upper airway, i.e., your mouth, nose and the back of your throat.

Try this: Tilt your head back, open your mouth and pretend that you're gargling. Feel that flutter at the back of your throat? That's your soft palate, which is believed to be a significant contributor for the 80% or more of people who can't stop snoring.

One in four people have a problem with chronic snoring and can't stop snoring on their own. If you're sharing a household with a snorer, you know that if they can't stop snoring, it will always be your problem too. On average, the bed partner of a snorer loses at least an hour of sleep every night. Because the partner's sleep is interrupted so frequently, it isn't deep and restful. As a result, they can be irritable, resentful, even unsafe at the wheel while driving. Sleep deprivation can also compromise the immune system and lead to low energy, decreased productivity and muddled thinking. Chronic snoring can even be a sign of a more serious health problem, obstructive sleep apnea (OSA).

Eventually, the lack of sleep can cause the snorer or bed partner to move to a different room. Imagine the strain that can have on a relationship. Or maybe you don't have to imagine it at all, because you're already living with a loved one who can't stop snoring.

Nasal Obstruction

Nasal airway obstruction can be uncomfortable and annoying.

Blocked nasal airway passages force you to breathe through your mouth, making simple, everyday activities such as eating, speaking, and sleeping more difficult. Decongestants, and anti-histamines offer only temporary relief. And, some more invasive surgical alternatives can seem extreme or fail to resolve the problem completely.

Now

Coblation Turbinate Reduction is a medical innovation used to treat nasal airway obstruction by both removing and shrinking soft tissue inside the turbinates. This revolutionary treatment:

  • Offers immediate and continued results
  • Approximately 50% reduction in nasal blockage within one week of treatment
  • Patients report sustained relief at 3, 6 and 12 months following treatment
  • May take as little as ten minutes

Over 50% Increase in

The proven, patented Coblation process has been used in over five million procedures by surgeons in ear, nose, and throat (ENT)

How is Coblation Turbinate Reduction Performed?

With Coblation, your doctor removes and shrinks soft tissue inside the enlarged turbinates with a specially designed device. This outpatient procedure takes less than 10 minutes. Patients typically return home shortly after the procedure, and can experience a 50% reduction in nasal obstruction within one week.

Coblation for Snoring Treatment

Turbinate coblation is an effective treatment for snoring that painlessly removes the tissue that causes nasal obstruction with radiofrequency technology. Patients who suffer from loud snoring have enlarged turbinates that affect their breathing and block the nasal passage. This procedure can also be used to treat chronic nasal congestion, facial pressure and nasal drainage.

After a local anesthetic a special wand is inserted into each turbinate to carefully remove excess tissue, instantaneously reducing the size of the turbinate. The wand then applies coblation therapy to the area to create a channel within the turbinate.

After the coblation procedure, the channel in the turbinate will shrink, relieving nasal obstruction and restoring normal breathing. This will help relieve snoring and other breathing problems.

Obstructive Sleep Apnea - OSA

Obstructive sleep apnea (OSA) or obstructive sleep apnea syndrome is the most common type of sleep apnea and is caused by obstruction of the upper airway. It is characterized by repetitive pauses in breathing during sleep, despite the effort to breathe, and is usually associated with a reduction in blood oxygen saturation. OSA is commonly accompanied with snoring.

Common signs of obstructive sleep apnea include unexplained daytime sleepiness, restless sleep, and loud snoring (with periods of silence followed by gasps). Less common symptoms are morning headaches; insomnia; trouble concentrating; mood changes such as irritability, anxiety and depression; forgetfulness; increased heart rate and/or blood pressure; decreased sex drive; unexplained weight gain; increased urination and/or nocturia; frequent heartburn or Gastroesophageal reflux disease; and heavy night sweats.

Dr. Eaton, I must admit that is was with great trepidation that I entered you office after prior unpleasant experiences in other offices. But I was proven wrong by your cheery receptionist, your friendly and efficient nurse and your own comforting “bedside” manner and (painless) skills. I left the office with a smile on my face. ”

Obstructive sleep apnea also appears to have a genetic component; those with a family history of OSA are more likely to develop it themselves. Lifestyle factors such as smoking may also increase the chances of developing OSA as the chemical irritants in smoke tend to inflame the soft tissue of the upper airway and promote fluid retention, both of which can result in a narrower airway. An individual may also experience or exacerbate OSA with the consumption of alcohol, sedatives, or any other medication that increases sleepiness as most of these drugs are also muscle relaxants. Most cases of OSA are believed to be caused by old age (natural or premature), decreased muscle tone, increased soft tissue around the airway (sometimes due to obesity), and structural features that give rise to a narrowed airway.

Diagnosis is often based on a combination of patient history and sleep studies, known as polysomnography.

An "event" can be either an apnea, characterised by complete cessation of airflow for at least 10 seconds, or a hypopnea in which airflow decreases by 50 percent for 10 seconds or decreases by 30 percent if there is an associated decrease in the oxygen saturation or an arousal from sleep (American Academy of Sleep Medicine Task Force, 1999). To grade the severity of sleep apnea, the number of events per hour is reported as the apnea-hypopnea index (AHI). An AHI of less than 5 is considered normal. An AHI of 5-15 is mild; 15-30 is moderate and more than 30 events per hour characterizes severe sleep apnea.

There are a variety of treatments for obstructive sleep apnea, depending on an individual's medical history, the severity of the disorder and, most importantly, the specific cause of the obstruction.

Obstructive sleep apnea in children is sometimes due to chronically enlarged tonsils and adenoids. Tonsillectomy and adenoidectomy is curative. The operation may be far from trivial, especially in the worst apnea cases, in which growth is retarded and abnormalities of the right heart may have developed. Even in these extreme cases, the surgery tends to cure not only the apnea and upper airway obstruction, but allows normal subsequent growth and development. Once the high end-expiratory pressures are relieved, the cardiovascular complications reverse themselves. The postoperative period in these children requires special precautions (see surgery and obstructive sleep apnea syndrome below).

Based upon the quality of my surgical experience and the efficient, empathic handling of my case, my intent is to encourage others to seek care through your practice. ”

The treatment for obstructive sleep apnea in adults with poor oropharyngeal airways secondary to heavy upper body type is varied. Unfortunately, in this most common type of obstructive sleep apnea, unlike some of the cases discussed above, reliable cures are not the rule.

Some treatments involve lifestyle changes, such as avoiding alcohol and medications that relax the central nervous system (for example, sedatives and muscle relaxants), losing weight, and quitting smoking. Some people are helped by special pillows or devices that keep them from sleeping on their backs, or oral appliances to keep the airway open during sleep. For those cases where these conservative methods are inadequate, doctors can recommend continuous positive airway pressure (CPAP), in which a face mask is attached to a tube and a machine that blows pressurized air into the mask and through the airway to keep it open. Some individuals may need a combination of therapies to successfully treat their sleep apnea.

Many surgical options exist for the treatment of obstructive sleep apnea. They are mostly offered for patients that cannot tolerate or are refractory to CPAP.

Injection Snoreplasty

Injection Snoreplasty is a surgical technique to eliminate snoring that works by reducing the flexibility of the soft palate and the uvula. The snoring sound is often produced by the vibrations of the soft palate and uvula when breathing. The principle is similar to several available snoring surgery options. The Injection Snoreplasty procedure involves injecting a sclerosing agent, Sotradecol®, into the soft palate and uvula. This agent causes an inflammatory reaction at the site that leads to the creation of scar tissue and the stiffening of the surrounding tissue. As the scar tissue contracts, the palate and uvula tighten and become shorter, thereby reducing snoring.

The procedure is comparitivley noninvasive and can be performed in the otolaryngologist's office under local anesthesic. The procedure normally takes 1-3 visits, scheduled months. Each visit should take about 15-20 minutes.

Snoring is significantly improved in 80-85% of carefully selected patients. With time, a relapse rate exists comparable to other forms of treatment. Approximately 90% of patients said they would be prepared to undergo the procedure again.

There is normally mild pain after the procedure that can usually be managed with pain relief but it can last several weeks. Some patients require narcotic pain medicine for control of their pain. Very rarely, there can be a serious reaction such as hives, asthma, hayfever and anaphylactic shock.

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