Loud Snoring

Snoring is the sound produced from the vibration of respiratory structures, as a result of obstructed air breathing while sleeping. Loud snoring may be due to obstructive sleep apnoea, nasal allergy, nasal obstruction or infection and enlargement of tonsils or adenoids. A thorough examination by an otolaryngologist will help identify the cause that leads to the most effective treatment. Whatever may be the underlying causes, it causes frustration and annoyance to patients and their bed or dwelling partners. Loud snoring is a warning sign and requires medical or surgical intervention. Here are the common causes of loud snoring and the treatment methods involved.

Loud Snoring

Obstructive Sleep Apnoea (OSA) is a sleep disorder in which the airflow within the nose is reduced or blocked. This is the most common cause of loud snoring. The condition may vary in severity from mild to chronic and is often associated with other medical conditions and therefore requires long-term management. Precise diagnostic methods and varied advanced treatment methods are available that successfully treat the condition. Non-surgical treatment method is first tried. If this is found ineffective, conservative procedures are tried. More aggressive operative methods are tried in situations where the doctors feel that conservative methods may not be effective. Second line of treatments for OSA is offered to patients where severity is chronic and when the doctor finds that other surgical procedures may not help.

Non-invasive Method

  • Continuous positive airway pressure therapy (CPAP) involves using a small device that helps a person with sleep apnoea to breathe more easily during sleep. It is a portable device and is fitted on the nose when required.

Conservative Methods

  • Uvulectomy is performed on patients with a large uvula that causes loud snoring. The procedure involves incising the inferior rim of the soft palate and uvula, thereby reducing its size.
  • Snoring as a result of nasal obstruction, depending on the severity is treated with medications and surgical procedures like Septoplasty, Somnoplasty and functional Rhinoplasty.
  • Nasal reconstruction involves Adenotonsillectomy. It is a surgical procedure often performed in children to correct loud snoring and restless sleep. Tonsils and adenoids can be removed in a number of ways and is best decided by the surgeon.
  • Palatal Implants involve placing three tiny woven implants made of polyester in the soft palate to help reduce vibration that causes snoring. The inserts are placed using minimally invasive technique.

Other surgical procedures

  • Palatal surgery also called UPPP is a common treatment for OSA and involves removal of tonsils and a portion of the soft palate. Another form though not very popular, involves removal of the posterior hard palate and anterior suspension of soft palate.
  • Genioglossal advancement surgery is performed that results in a forward displacement of tongue
  • Thyrohyoid suspension procedure involves advancing the hyoid bone anterior or interior to the thyroid cartilage.

More aggressive surgical methods

  • Procedures called Maxillary-mandibular advancement to widen the airway and Tracheotomy to cure OSA that results in loud snoring are performed for rare cases with chronic OSA syndrome.

Authored by Dr Shailesh Pandey, ENT Specialist

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