Essentially, snoring is a sound resulting from turbulent airflow that causes tissues to vibrate during sleep. While we are asleep, turbulent airflow can cause the tissues of the palate (roof of the mouth) and throat to vibrate, giving rise to snoring.
Different people who snore have different reasons for the narrowing. The narrowing can be in the nose, mouth, or throat.
- On the lateral side (the wall of the nose closer to the cheeks) of each passage, there are three nasal turbinates, which are long, cylindrical-shaped structures that lie roughly parallel to the floor of the nose. If the blood vessels in the turbinates increase in size, the turbinate as a whole swells, and the flow of air decreases.
- The soft palate is a muscular extension of the bony roof of the mouth (hard palate). It is shaped like a sheet attached at three sides and hanging freely in the back of the mouth. If it is too long or floppy, it can vibrate and cause snoring.
- The uvulais the small extension at the back of the soft palate. It assists with the function of the soft palate. The uvula is suspended from the center and back of the soft palate. An abnormally long or thick uvula also can contribute to snoring.
- The tonsilsare designed to detect and fight infections often, the tonsils do not return to their normal size after the infection is gone. They can remain enlarged (hypertrophied) and can narrow the airway vibrate, and cause snoring.
- The base of the tongueis the part of the tongue that is the farthest back in the mouth. The tongue is a large muscle that is important for directing food while chewing and swallowing. If the back of the tongue is large or if the tongue is able to slip backwards, it can narrow the space through which air flows in the pharynx, which can lead to vibrations and snoring.
Surgeries for snoring, There are four basic surgical procedures:
- Uvulopalatopharyngoplasty (UPPP)
- Laser-assisted uvuloplatoplasty (LAUP)
- Platal stiffening operations (CAPSO)
- Radio-frequency ablation (Somnoplasty)
- Co-ablation assisted Sinus Surgery (Somnoplasty)
Radio-frequency ablation is designed to shrink redundant tissue of the soft palate. The treatment involves heating the inner tissue to 85ºC which results in the tissue beneath the skin being scarred.
Somnoplasty is minimally invasive and creates controlled lesions that have little effect on surrounding tissues. The procedure takes about 20 minutes, Somnoplasty is a low-morbidity, can be performed under local anesthesia in an out-patient clinic and does not carry the same complications as the other procedures. Somnoplasty generally requires the patient to undergo several treatment sessions but unlike the other procedures is much less painful. The applications of Somnoplasty are expanding and to date it is useful for turbinate and palate based snoring.
- Complications of tongue base reduction with radiofrequency tissue ablation on obstructive sleep apnea hypopnea syndrome, Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi.2010 Jul;45 (7):574-7.
- Effectiveness of multilevel (tongue and palate) radiofrequency tissue ablation for patients with obstructive sleep apnea syndrome. Steward DL1, 2004 Dec;114(12):2073-84.