New devices and surgery may offer help for problem snoring.

By Denise Mann
WebMD Feature

Reviewed By Charlotte Grayson

At best, snorers and their loved ones awake feeling fatigued. At worst, snoring can contribute to serious conditions such as high blood pressure. But new medical treatments can help you stop snoring.

While sleep apnea, a breathing disorder characterized by brief interruptions of breathing during sleep, tends to garner all the sleep headlines, recent research has shown that plain, old snoring is more than just a social problem, says Robert W. Clark, MD, medical director of the Regional Sleep Disorders Center at the Columbus Community Hospital in Columbus, Ohio. "One doesn't have to stop breathing to have a problem."

In fact, researchers out of Penn State College of Medicine in State College, Penn. found that younger adults who snore, especially those who do not have any other sleeping disorders, are one-and-a-half times more likely to suffer from high blood pressure than those who don't.

"We used to think regular snoring without pauses in breathing was OK, but we were wrong," Clarke says. "Recent studies have linked it to high blood pressure. And, often people who snore will decompensate and develop sleep apnea."

If you've tried to stop snoring with natural remedies such as sleeping on your side, using nasal strips, losing weight, and cutting out alcohol before bedtime, don't despair. Your next step is to get an overnight evaluation at a sleep clinic.

"Not doing this is like diagnosing chest pain without an electrocardiogram (EKG)," Clarke says. Once sleep doctors identify the source of your snoring and its cause, they can better choose treatment. Here are the key medical treatments available.

Decongestants

Allergies and infection can cause swelling of the nose and throat, leading to snoring. If you snore because of allergies or a nasal infection, try taking a decongestant before bedtime to reduce the swelling, says Mark Mahowald, MD, director of the Minnesota Regional Sleep Disorders Center.

Continuous Positive Airway Pressure Devices

A promising and common stop snoring therapy is called nasal continuous positive airway pressure (CPAP). The CPAP machine is about the size of a shoebox and pushes air through the airway at a pressure high enough to keep the airway open during sleep. A flexible tube connects the machine with a mask that is worn over the nose and/or mouth.

"CPAP is by far the best thing going," Clarke tells WebMD. "The beauty of CPAP is that it doesn't matter where the obstruction is occurring and it is very safe."

Mandibular Advancement Devices

Mahowald says his patients can often stop snoring by using a mandibular advancement device. This is a "tooth guard-like device that juts the lower jaw and the base of the tongue forward," he explains.

"This works in about 75% of individuals." he says, although "some people are better candidates than others." For example, these devices are not recommended for people who already have a protruding chin, an under bite or dentures. Most dentists can customize these devices.

"The price of mandibular devices varies from $300 to well over $1,000, so price should be a consideration," he says. Ask the doctor how many they have made and what their personal success rate is.

Surgery

Surgery should always be a last resort in your effort to stop snoring, say Mahowald and Clarke. That said, there are several surgical procedures available for snorers, including:

Uvulopalathopharyngoplasty involves removing excess throat tissues such as tonsils and parts of the soft palate to expand the airway. There is also laser-assisted uvuloplatoplasty (LAUP), which uses a laser to remove part of the uvula and palate. More than one session may be needed with LAUP.
Another relatively new surgical procedure, somnoplasty, shrinks excess tissue via very low levels of radiofrequency energy. The tissue is then naturally reabsorbed by the body. Performed under local anesthesia in less than 10 minutes, somnoplasty is designed to minimize the bleeding and pain associated with other techniques.
An even newer type of procedure using radiofrequency energy is called coblation-channeling. Unlike somnoplasty and others which heats or shrinks tissue, coblation-channeling clears blocked airways by both shrinking and removing tissue.
Doctors can also inject sclerosing liquid into soft palate tissue to cause irritation and scarring. This tightens the soft palate, making it less likely to rub against the tongue or tonsils and cause snoring.
If snoring stems from the nose, nasal surgery to remove obstructions in the nose or to correct a deviated septum may also help you stop snoring.

"The drawback is that although in the short term (surgical procedures) may be very effective, over the long haul, most people are snoring again," Mahowald says.

The bottom line? Ask your doctor what surgery, if any, may be appropriate for your snoring and what risks are involved.

Published Aug. 21, 2003.

SOURCES: Mark Mahowald, MD, director of the Minnesota Regional Sleep Disorders Center and professor of neurology at the University of Minneapolis in Minnesota. Robert W. Clark, MD, medical director of the Regional Sleep Disorders Center at the Columbus Community Hospital in Columbus, Ohio.

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