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At least 343 records · Page 19Linked to original sources
PubMed2001

Laser-assisted uvulopalatoplasty for snoring: medium- to long-term subjective and objective analysis.

OBJECTIVE: To assess the subjective and objective medium- to long-term results of laser-assisted uvulopalatoplasty for snoring. DESIGN: A nonrandomized, prospective, before-after trial. SUBJECTS AND INTERVENTIONS: Fourteen patients underwent laser-assisted uvulopalatoplasty surgery; 2 surgical techniques, which differ with respect to the mode of midline palatal vaporization, were used. MAIN OUTCOME MEASURES: Subjective analysis included a preoperative and 2 postoperative evaluations of the state of snoring: 4 weeks and 10.1 +/- 7.9 months (mean +/- SD) after completion of last laser treatment. In addition, a score on 5 other sleep-related symptoms was recorded before treatment and after 10.1 +/- 7.9 months; at that time, patients also estimated their overall satisfaction with the procedure. Objective analysis included preoperative nocturnal polysomnographic studies that were repeated postoperatively. RESULTS: A decline in snoring improvement from 79% (11/14) to 57% (8/14) was recorded; furthermore, state of snoring worsened from 7% (1/14) to 21% (3/14). Likewise, reevaluation of the 5 other sleep-related symptoms at the final follow-up visit uncovered a 57% improvement rate. Overall satisfaction with the procedure was 43%. The results of the postoperative objective studies corresponded to those of the subjective ones and demonstrated significant worsening of respiratory disturbance index in 3 (21%) of the 14 patients, who became mildly apneic. These findings were encountered with both laser techniques. CONCLUSIONS: The favorable subjective short-term results of laser-assisted uvulopalatoplasty deteriorated with time. In addition, postoperative nocturnal polysomnography showed that the procedure caused mild obstructive sleep apnea in a considerable number of patients who formerly were nonapneic snorers. These findings may be related to velopharyngeal narrowing and progressive palatal fibrosis, caused by the thermal damage inflicted by the laser beam.

Adult↗
PubMed1990

Snoring can be reduced when the nasal airflow is increased by the nasal dilator Nozovent.

The ability to breath through the nose can be increased above normal by dilating the narrow nasal valve area with the plastic nasal device Nozovent. For 10 nights, 10 patients used Nozovent every other night, and the sleeping partners of the patients judged the snoring sound level using a snoring score. The results showed a significant decrease in snoring, from moderate to slight, when Nozovent was used, or from a barely tolerable to a tolerable noise level. In about 1 night out of 4, when the nostrils were dilated, the sleeping partners did not note any snoring at all. An increased nasal airflow is achieved with less negative intrathoracic pressure, which presumably results in less opportunities for vibrations of the soft palate.

Adult↗
PubMed1996

Headache, snoring and sleep apnoea.

To evaluate reported headache prevalence among the general population and patients suffering from snoring and obstructive sleep apnoea syndrome (OSAS), a cross-sectional study was performed among those aged 30-64 years residing in Kopparberg county in central Sweden. Consecutive patients referred to the sleep laboratory in the catchment area who fulfilled objective diagnostic criteria (snorers = 448, OSAS = 324) and a random sample of the general population (n = 583) responded to the same questionnaire. Patients were selected following sleep apnoea screening with 100% specificity for both OSAS and snoring. Responders from the general population were divided into snorers or non-snorers on the basis of self-report. To validate the self-report question on snoring in the questionnaire, 50 males and 49 females, randomly selected from the sample of the general population, underwent sleep apnoea screening in their homes. Headache among both men and women was found to be more prevalent among heavy snorers and OSAS patients compared with the control group. Morning headache, in particular, was at least three times more common among male and female heavy snorers and OSAS patients then among the general population. Headache in the control group was more common among snorers than non-snorers. Among responders, 5% of the general population reported experiencing headache often or very often upon awakening. For the heavy snoring and OSAS groups, 18% reported experiencing headache often or very often upon awakening. The results indicate that headache is common among heavy snorers and OSAS patients regardless of gender.

Adult↗
PubMed2000

[Pharyngolaryngoscopic findings in patients with obstructive sleep apnea syndrome and primary snoring].

BACKGROUND AND OBJECTIVE: The localization of an upper airway collapse in snorers and patients suffering from obstructive sleep apnea was a subject frequently discussed in the last few years. Pharyngolaryngoscopy during sleep or drug-induced sleep allows evaluation of upper airway conditions. PATIENTS/METHODS: A total of 324 patients suffering from snoring or obstructive sleep apnea underwent flexible pharyngolaryngoscopy while awake and under propofol-induced sedation in the course of routine diagnostic procedures in the sleeping lab. In this study, the results of pharyngolaryngoscopy are compared to results of the Müller maneuver and polysomnographic recordings. The therapeutic consequences of this additional investigation are discussed. RESULTS: In 95% of cases snoring was observed during drug-induced sleep. A significant discrepancy was seen between results of the endoscopy while being awake (Müller maneuver) and during drug-induced sleep. The degree of collapse differed significantly in the area of the base of the tongue. Severe collapse was seen much more often with pharyngoscopy during drug-induced sleep compared to the results during the Müller maneuver. CONCLUSIONS: The collapsibility in the area of the base of the tongue correlated with higher results in the RDI (respiratory disturbance index) registered with standard polysomnography. Snoring and upper airway collapse were easily surveyed, and the pharyngolaryngoscopy during propofol-induced sleep proved to be a simple, safe, readily controllable and effective supplementary diagnostic device for the diagnosis and treatment of obstructive sleep apnea and snoring.

Adolescent↗
PubMed2002

[Success rate and complications of primary, laser-assisted uvuloplasty in patients with snoring].

MATERIALS AND METHODS: We performed primary laser-assisted uvulopalatoplasty (LAUP) with a CO2 laser (20 W) on 152 patients (group C, M:145, F:7, mean AHI 9) with snoring under local anesthesia (group C1, laser CW mode: n = 101 and group C2.1, laser WDH mode: n = 31) and under intranasal intubation anesthesia (group C2.2, laser WDH mode: n = 20). The indication was based on recently established classification criteria (CC). In group C2.2 the correction was made in ten cases using the new version of LAUP (TR, tangential reduction). The follow-up examination ensued 1 year after the operation. RESULTS: Serious and lasting complications did not arise. The mean length of pain was 7.8 days and was less when using the laser in the WDH mode (pulse 0.4 s, pause 0.2 s, 20 W) (group C2.1, 6.9 days; group C2.2, 5.1 days). The patients reported no bothersome snoring in 88% of the cases and no snoring in 43% of the cases. The rate of no snoring was considerably higher in patients of the C2 groups (60%). CONCLUSION: The results show that by strict adherence to the new classification criteria, using lasers in the WDH mode, and using the TR method under intranasal intubation anesthesia better effects could be achieved than those published in the current literature. Significant complications did not occur. Under these conditions, a broader indication for LAUP as a so-called secondary LAUP as an integral part of step-by-step combination therapy with nCPAP and/or a mandibular protruding device has been verified and can be seen as therapeutically effective.

Adult↗
PubMed2001

Treatment of snoring and obstructive sleep apnea with a mandibular protruding device: an open-label study.

The study objectives were to describe the changes in signs and symptoms of obstructive sleep apnea (OSA) and snoring using a mandibular protruding device (MPD) and to define the group of responders. The design of the study was a nonrandomized, open-labeled, prospective clinical study with a duration of 6 months. The setting was a hospital sleep laboratory and an ear, nose, and throat and dental outpatient clinic. Patients included 35 individuals treated: 22 with a diagnosis of OSA and 13 who snored without apnea. The intervention before MPD prescription entailed a medical examination, a one-night somnographic registration, a questionnaire, and a clinical jaw function examination. All procedures were iterated at the 6-month follow-up. When the patients used the MPD, the subjective symptoms decreased significantly (p < 0.001). Twenty-four of the 35 patients were classified as responders, i.e., reduced their symptoms > or = 50%. In the groups of OSA patients, the mean peak intensity of the snoring sound decreased from 71.6 dB to 62.0 dB (p < 0.001) and in the group of snorers, from 63.5 dB to 57.5 dB (p < 0.05). Eighteen of the 22 OSA patients decreased their ODI values by > or = 50% (responders). The mean ODI decreased from 15.4 to 3.5 (p < 0.001) and the blood oxygen saturation, SaO(2) nadir, increased from mean 81.9 to 85.7 (n.s.). Most patients with tongue base hyperplasia were classified as responders to the MPD treatment. In conclusion, a 6-month perspective shows that the MPD could be an effective treatment in reducing signs and symptoms of OSA and/or snoring, the compliance was acceptable and only minor adverse events occurred.

Adult↗
PubMed2004

Sleep apnea avoidance pillow effects on obstructive sleep apnea syndrome and snoring.

UNLABELLED: The study was performed to determine the ability of a new inclined pillow to treat snoring and obstructive sleep apnea syndrome. The SONA Pillow is a triangular pillow with space to place your arm under the head while sleeping on the side. Twenty-two patients with nocturnal polysomnogram (NPSG)-proven obstructive sleep apnea syndrome were included in this study; the group included 11 mild, 8 moderate, and 3 severe sleep apnea patients. All patients had a second attended NPSG performed while utilizing this specific inclined pillow. The pillow was found to be an effective and easily used treatment for mild (respiratory disturbance index [RDI] 5 to 19) and moderate (RDI 20 to 40) obstructive sleep apnea and snoring. In this group, RDI ranged from 5.1 to 35.2 and decreased on the average from 17 events per hour to fewer than 5 events per hour while utilizing the inclined pillow (<0.0001). Also, a statistically significant difference was noted in rapid eye movement (REM) RDI decrement in all patients with mild to moderate sleep apnea (p=0.001) and the increase in SaO2 was also significant (p=0.004). Overall, snoring was decreased or eliminated (p=0.017). CONCLUSION: A uniquely designed pillow (SONA Pillow) is effective in reducing the number of events in patients with mild to moderate obstructive sleep apnea. Using this pillow also reduces snoring.

Adult↗
PubMed1993

Does snoring intensity predict flow limitation or respiratory effort during sleep?

We tested whether snoring sound intensity could be an accurate predictor of the degree of respiratory effort or the decrease of inspiratory volume during partially obstructed breathing in sleep. Six snorers were investigated with nocturnal polygraphic monitoring including measurement of esophageal pressure (Pes), airflow (pneumotachometer and face mask, indicating tidal volume [VT]), and snoring sound intensity (SSI) measured in decibels. SSI was a poor predictor of flow limitation during snoring. Considerable between- and within-subject variance did not allow establishment of models for the interdependence between VT and SSI. The increase in peak-negative inspiratory efforts was better predicted by SSI. Individual multiple correlation analyses of Pes on SSI indicated a positive interdependence in all subjects. Calculation of ecological correlations with subject means of Pes and SSI was performed. SSI significantly predicted the level of peak-negative inspiratory effort during obstructed, noisy breathing for a given subject. Monitoring of snoring sound intensity may be a useful indicator identifying subjects performing high peak negative inspiratory efforts with obstructed, noisy breathing during sleep.

Analysis of Variance↗
PubMed1995

Biomechanics of snoring.

A large proportion of the population either snores or suffers the snoring of others. Recent advances with the use of fibre-optic endoscopes have enabled surgeons to observe the inside of the pharynx while a patient is asleep and snoring. In this article we look at the underlying structure of the upper airway and explain, with the use of simple mechanical models, the aerodynamic events occurring inside the upper airway during snoring.

Adult↗
PubMed2006

QT dispersion in non-apneic simple snoring patients and the effect of surgical therapy on QT dispersion.

AIM: Increased QT dispersion in cases of obstructive sleep apnea, which may induce serious arrhythmias, is a well-known process. However, there is little information about the QT dispersion in patients with simple snoring without apnea. We investigated QT dispersion in snoring and the effect of surgical therapy on QT dispersion. METHODS: One hundred and sixty two patients with simple snoring without apnea were included in this study. Patients had polysomnography and surface electrocardiography (ECG) on the pre-operative 1st week and post-operative 4th week. The patients underwent one of the three surgical procedures, which include uvulopalatopharyngoplasty, laser assisted uvulopalatoplasty, and cautery assisted uvulopalatoplasty. QT dispersion was calculated in each patient from pre-operative and post-operative surface ECG. Pre-operative and post-operative values were compared using the student's t test. P<0.05 was considered statistically significant. RESULTS: One hundred and fourteen of the patients were male, 48 were female, and the mean age was 35.2+/-14.1 years (range: 21-51). No improvements were observed in 9 of the patients. Surgical interventions were successful in 153 patients (94%). Post-operative QTc max and QTc dispersion values were significantly shortened, and QTc min was increased compared to the pre-operative values (449.6+/-6.2 vs. 440.9+/-20.8, and 68.2+/-8.4 vs. 43.8+/-6.2, and 381.3+/-7.8 vs. 397.0+/-5.9 respectively; P=0.001). CONCLUSION: This study shows that QT dispersion is increased in simple snoring patients without apnea and that QT dispersion decreases after surgical interventions.

Adult↗
PubMed2004

Complications of laser-assisted uvulopalatopharyngoplasty (LA-UPPP) and radiofrequency treatments of snoring and chronic nasal congestion: a 10-year review of 5,600 patients.

PURPOSE: Recent laser and radiofrequency techniques for the treatment of snoring have provided improvements, but intraoperative and postoperative risks, complications, and long-term results have not been explored in a statistically large enough sample of patients. The goal of this article is to provide practitioners with important data and guidelines to help them in decision-making and prepare them to anticipate problems and recommend a systematic approach to avoid or treat complications. PATIENTS AND METHODS: This investigation was a retrospective review of 5,600 cases, performed over a 10-year period by a single investigator, in a private practice setting. The data on complications were gathered from chart review as well as questionnaires filled out on each patient and by patient reports. The inclusion criteria for this review were: 1) patients with a history of chronic snoring or nasal congestion; 2) patients with an American Society of Anesthesiologists physical status classification (ASA) Classes I or II medical history; 3) patients provide a detailed preoperative snoring questionnaires; 4) patients provide informed consent; 5) patients were followed for a minimum of 2 years following surgery; 6) patients completed a comprehensive postoperative survey; 7) operative report stating the exact nature of any complications; 8) surgeons provided a clinical assessment; 9) sleep apnea reports if available; and 10) patient body mass index of less than 30 kg/m2. RESULTS: Laser-assisted uvulopalatopharyngoplasty (LA-UPPP) was used for the treatment of snoring and mild obstructive sleep apnea in all cases; 40% of patients also had simultaneous nasal radioablation. No fatalities were recorded and fewer than 3% of patients had long-term complications. The most common intraoperative complication was bleeding, which occurred in 9.5% of patients. CONCLUSION: Reducing the amount of tissue resected from the soft palate helped reduce or eliminate the common complications of traditional uvulopalatopharyngoplasty procedures. LA-UPPP and radioablation procedures are effective, safe, and can be carried out in an office setting equipped with anesthesia monitors and services. The complications associated with the procedure were rare and usually manageable.

Adult↗
PubMed2005

Long-term results of palatal implants for primary snoring.

OBJECTIVE: To determine the safety and efficacy of the Pillar Palatal Implant System over a 1-year follow-up period. STUDY DESIGN AND SETTING: In this prospective study, 40 healthy adult patients with primary snoring due to palatal flutter were treated after clinical, polysomnographic, and endoscopic examination. Under local anesthesia 3 implants were placed into the soft palate. Postoperative morbidity and functional parameters were assessed. Snoring and daytime sleepiness were assessed before and 90, 180, and 360 days after surgery. Objective data were obtained by polysomnography and SNAP-recording before and 90 days after treatment. RESULTS: All implants were placed without complications. A total of 13 implants partially extruded uneventfully in 10 patients. Functional parameters remained unchanged. After 1 year, snoring was reduced from 7.1 +/- 1.9 to 4.8 +/- 2.5 (Visual-Analogue-Scale, P < 0.05) and daytime sleepiness from 6.1 +/- 3.2 to 4.9 +/- 3.1 (Epworth-Sleepiness-Scale, P < 0.05). SNAP data and polysomnography parameters showed clinically irrelevant changes. CONCLUSION: Our data demonstrate a significant decrease in snoring and daytime sleepiness over a period of one year.

Adult↗
PubMed2006

Palatal implants for the treatment of snoring: long-term results.

OBJECTIVE: To evaluate the safety and long-term effectiveness of a new treatment for snoring using permanent palatal implants. STUDY DESIGN: Prospective study with 35 patients referred to the clinic for the treatment of snoring. The patients were followed for 1 year, and a sleep analysis was performed and repeated at 360 days. During the procedure, 3 braided polyethylene terephthalate implants were placed in the palate of each patient. RESULTS: The average duration for nonnarcotic analgesics was 1.3 days. No adverse events were observed. The mean snoring intensity was reduced from 7.1 at baseline to 4.8 at 1 year (P < 0.001). Bed partner satisfaction rate was very high at 70.6% after 1 year. Six patients (17.8%) experienced a total of 9 partial extrusions. CONCLUSIONS: The palatal implant system is safe, and the effectiveness in treating snoring is comparable to other surgical methods. Advantages are virtually no tissue damage and minimal patient discomfort as a result of one standardized, low-cost procedure. EBM RATING: C-4.

Adult↗
PubMed1985

Snoring as a risk factor for hypertension and angina pectoris.

The association of snoring with hypertension and ischaemic heart disease (IHD) was tested by postal questionnaire in a population of 3847 men and 3664 women aged 40-69 years. Hypertension associated highly significantly with snoring, the relative risk (RR) of hypertension between habitual snorers and never snorers being 1.94 in men and 3.19 in women. This association was also found when adjusting for body-mass index. A significant association between angina pectoris and habitual snoring was observed in men (RR = 2.22). In women the relative risk was not significant. An association between habitual snoring and angina pectoris in men was also found after adjusting for hypertension and body-mass index (RR = 2.01, p less than 0.01). The relative risks for myocardial infarction and hospital admission for IHD for habitual snorers were non-significant.

Adult↗
PubMed2000

Nasalance scores in snoring children with obstructive symptoms.

OBJECTIVE: Snoring and the sleep apnea syndrome (OSAS) in children are usually caused by adenotonsillar hypertrophy, which may affect air escape into the nose and nasal resonance. A microcomputer-based system makes it possible to objectively determine whether the oral passage is adequately separated from the nasal passage during phonation. The score thus obtained is called nasalance. This study was conducted to verify whether there exists differences in nasalance between primary snorers and OSAS-children. DESIGN: Fifty-three habitually snoring children (31 boys), mean age 6.1 years (range 3.2-10.5 years), were subjected to overnight sleep polygraphy (PG) and nasalance measurements with the Nasometer 6200. The study was successfully repeated 6 months later on 36 children. RESULTS: Nineteen children had obstructive apnea-h ypopneaindex (OAHI)> 1 on overnight polygraphy (OSAS-children), while 32 were considered primary snorers (PS), (OAHI<1). No statistically significant difference in nasalance scores was found between the OSAS- and PS children. Both groups of children had somewhat higher mean nasalance values both for oral and nasal passage sentences than the normative values for Finnish speech. In general, the most habitual snorers had lower nasalance scores than the less frequently snoring children (P=0.05). Earlier adenoidectomy or palatine tonsillar size did not have a significant influence on the nasalance. Adenotonsillectomy did not affect the nasalance scores of the nine children operated on during the follow-up period. CONCLUSIONS: According to the present study, nasalance measurements cannot be used to predict the incidence of OSAS among snoring children.

Child↗
PubMed1998

A magnetic appliance for treatment of snoring patients with and without obstructive sleep apnea.

The aim of this intraindividual study was to investigate the effects of an intraoral magnetic appliance on snoring, daytime sleepiness, and blood oxygen saturation, as well as to analyze the effects on the craniomandibular complex and investigate the response of the device to craniofacial structure. Twenty-five male patients (mean age 54.1 years, SD 11.44) with handicapping snoring or obstructed sleep apnea (OSAS) participated in the study. The appliance consisted of a maxillary and a mandibular occlusal acrylic splint. In each splint, four cylindrical neodymium-iron-boron magnets were embedded and oriented to produce intermaxillary forces that pulled the mandible forward. After a treatment period of 6 months, questionnaires were used for registration of the patients' subjective rating of daytime sleepiness and their close relatives' opinions about the snoring. The treatment effects on the temporomandibular joint were evaluated, according to Helkimos' anamnestic and dysfunctional index, and nightly registration of blood oxygen saturation was performed before and after 6 months of treatment. The effects on craniofacial skeletal and soft tissue profiles were analyzed cephalometrically. All patients easily accepted the magnetic appliance. The main symptoms, snoring and daytime sleepiness, decreased significantly when the magnet appliance was inserted (p = 0.0001 and p = 0.0002, respectively). The blood oxygen saturation during sleep was also improved (p = 0.012). The treatment had no aberrant effects on the temporomandibular joint status. The appliance made the mandible rotate downward and backward, mean 7.8 degrees, and this rotation mostly camouflaged the forward movement of the mandible. There was no significant influence on the hyoid bone position, but the hypopharyngeal airway space increased, the tongue base was lowered, and the contact between the tongue and soft palate was reduced significantly.

Adult↗
PubMed1991

Cephalometric analysis of permanently snoring patients with and without obstructive sleep apnea syndrome.

Habitual heavy snoring may be considered a preliminary stage of sleep apnea syndrome. This investigation deals with the craniofacial morphology of 51 heavily snoring patients, with and without obstructive sleep apnea, and with 28 healthy control patients. The apnea group showed a reduced posterior airway and a posterior rotation of the mandible. Reduction of the anterior-posterior diameter of the cranial base, maxilla and mandible and vertical reduction of the posterior facial height appeared to be common facial characteristics in both snoring and apnea patients. These findings indicate an anatomical disposition for snoring and apnea.

Body Height↗
PubMed2003

Snoring and the metabolic syndrome in women.

OBJECTIVE: The main objective was to examine the association between metabolic syndrome, snoring and sleep quality among women. METHODS: The study sample comprised healthy women (30-65 years) from the greater Stockholm area. Snoring and sleep quality were measured by the Karolinska Sleep Questionnaire. The metabolic syndrome was defined as the presence of two or more of the following components: (1) fasting serum glucose level > or =7.0 mmol/L; (2) arterial blood pressure > or =140/90 mmHg; (3) fasting serum triglycerides > or =1.7 mmol/L and/or HDL cholesterol <1.05 mmol/L; and (4) obesity (waist-to-hip ratio >0.85 and/or BMI > or =28 kg/m2). RESULTS: After adjustment for age, the risk ratio of metabolic syndrome among snorers as compared to non-snorers was 4.50 (95% CI: 1.71-11.86; p=0.002). This association persisted after controlling for menopausal status, educational level, smoking, fatigue and exercise habits. Poor sleep quality showed a trend (OR: 3.31; 95% CI: 0.89-12.21; p=0.073) towards an increased risk for metabolic syndrome, but this did not reach statistical significance. CONCLUSIONS: Snoring may be a strong predictor for metabolic syndrome in middle-aged women. These findings show that snoring women are not only at increased risk for individual risk factors associated with cardiovascular disease and type 2 diabetes, but also for metabolic syndrome.

Adult↗