Snoring is a rough rattling noise made on inspiration during sleep by vibration of the soft palate (the back of the roof of the mouth) and the uvula (the prominent structure dangling down at the back of the mouth).
On inspiration, air on its way to the lungs travels by the tongue, the soft palate, the uvula, and the tonsils. When a person is awake, the muscles in the back of the throat tighten to hold these structures in place and prevent them from collapsing and vibrating in the airway. During sleep, the soft palate and uvula may vibrate causing the sounds of snoring.
Sleep apnea is a common but serious sleep disorder where your breathing is briefly interrupted when you’re asleep. If you have sleep apnea, you’re probably not aware of these short breathing pauses that occur hundreds of times a night, jolting you out of your natural sleep rhythm. All you know is that you don’t feel as energetic, mentally sharp, or productive during the day as you should do.
The most common type of sleep apnea—obstructive sleep apnea—occurs when the airway is blocked, causing pauses in breathing and loud snoring.
Common symptoms of sleep apnea include:
- Loud or frequent snoring
- Silent pauses in breathing
- Choking or gasping sounds
- Daytime sleepiness or fatigue
- Unrefreshing sleep
- Insomnia
- Morning headaches
- Nocturia (waking during the night to go to the bathroom)
- Difficulty concentrating
- Memory loss
- Decreased sexual desire
- Irritability
Treatments for obstructive sleep apnea may include:
- Continuous positive airway pressure (CPAP). A machine that delivers air pressure through a mask placed over your nose while you sleep
- Expiratory positive airway pressure (EPAP). These small, single-use devices are placed over each nostril before you go to sleep
- Surgical tissue removal from the rear of your mouth and top of your throat. During this procedure, which is called uvulopalatopharyngoplasty, your tonsils and adenoids usually are removed as well. It’s less effective than CPAP, and isn’t considered a reliable treatment for obstructive sleep apnea
- Surgical jaw repositioning
- Plastic rods surgically implanted into the soft palate
- You may need this form of surgery if other treatments have failed and you have severe, life-threatening sleep apnea
- Ablation therapy
Obstructive sleep apnea syndrome is due to pharyngeal obstructions, which can take place at the level of the soft palate. Temperature-controlled radiofrequency ablation has been introduced as being capable of reducing soft tissue volume and excessive compliance.
Radiofrequency ablation (RFA) is generally conducted in the outpatient setting, using either local anesthetics or conscious sedation anesthesia. The procedure itself generally lasts under 3 minutes. The desired tissue (either the tongue or the palate) is generally approached through the mouth, without the need for incisions.
If the tongue is being targeted, this can be done either from on top (dorsal) of the tongue or underneath (ventral). Respective approaches are usually at the discretion of the treating physician
References:
- National Heart, Lung and Blood Institute USA
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- American Academy of Otolaryngology – Head and Neck Surgery
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