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Chapter 7: How to 'treat' or prevent snoring?


Occasionally, surgery is the only answer…

The first thing to say is that there are a minority of cases where people snore because they have a medical problem that needs surgical attention.

For example, there are a small number of cases where there are defects of the tongue, soft palate and/or uvula (which plays a key role in producing the sound of your voice) which between them exacerbate the tendency to snore.

This particular situation can only be dealt with by treating the problem surgically. The surgical procedure involved, known as a uvulopalatopharyngoplasty, is designed to widen the airway of the patient by removing soft-tissue from the back of the throat.

The surgery is, however, quite invasive, and also carries a significant risk of unsatisfactory final results. In particular, there is a chance that as a result of surgery, the scar tissue left will in fact further restrict the air flow in the throat instead of freeing it up.

Alternatively, a relatively modern and far less radical treatment known as Radiofrequency Ablation (RFA) is sometimes used to treat snorers. In this situation, a special heat and radiofrequency generating machine is used to burn the flesh underneath the skin of the soft tissue at the back of the throat.

The theory is that when this burned area recovers, it will comprise scar tissue, which is by nature considerably harder and less flexible than the original soft tissue. Thus, the propensity for this tissue to vibrate and cause the snoring noise is significantly reduced.

Although this sounds singularly painful, the fact is that the pain and discomfort is usually minimal and the treatment can be performed very quickly (often as an outpatient). However, although RFA often reduces the severity of the snoring, it does not usually stop the patient snoring entirely.

In a similar manner, problems of the nose that reduce the ability to breath through the mouth (whether they are natural or caused by accidents as highlighted previously) will likewise need surgical treatment in order to effect a permanent repair, thereby reducing or completely removing the tendency to snore.

Over the counter medicines

There are pills, potions, sprays and medicines available over-thecounter in many a local pharmacy or store that are claimed to be capable of treating or even curing your snoring habit.

However, for some idea of how effective the majority of these concoctions are likely to be, it is necessary to do no more than pay heed to the advices of Mark Mahowald, MD, who is the Director of the Minnesota Regional Sleep Disorders Center and is also a past president of the American Academy of Sleep Medicine.

On the subject of over-the-counter pills and sprays, the Doctor comments thus: ‘There are all sorts of sprays, pills and tablets that claim to make snoring better, but I have yet to see any validation by scientific studies to support those claims’.

Whilst a lack of scientific validation does not necessarily prove that no over the counter medical treatments for snoring work, it certainly suggests that they are unlikely to be particularly effective for the majority of people who are chronic or habitual snorers.

Dental or orthodontic treatment

Some people can be treated for their snoring habit with a special dental appliance known as a ‘mandibular advancement splint’ (MAS).

The idea behind the MAS is that it pushes the patients lower jaw forward slightly, so that their tongue is pulled forward by a degree at the same time. This is a relatively common treatment that is generally performed by a dentist or orthodontist, often one who specializes in dentistry related to sleep apnea problems.

Such devices generally prove to be effective in reducing or eliminating the patients snoring problem, particularly if that problem is related to a corresponding sleep apnea condition.

It is even possible to buy over the counter MAS devices, which are often manufactured from a polymer and have the appearance of the kind of gum shields or mouth protection devices favored by sports people. The problem with adopting this ‘do it yourself’ approach, however, is the fact that, whilst the MAS device itself is perfectly sound, it is likely that the person who purchased that device has no experience of how to fit it properly.

Given that the whole objective of the MAS is to slightly alter the position of the patients jaw, it must be apparent that corrector fitment of the device is absolutely critical.

Furthermore, professionally fitted MAS devices are adjustable. Thus, the professional dentist or orthodontist is able to make any necessary adjustments as they go along.

For example, if the device as initially fitted is ineffective, the lower jaw can be extended slightly further by adjusting the device in order to make sure that it works properly in the future. In contrast, if the initial extension is too great then jaw pain will be the result, so, again, having an adjustable device professionally fitted is a major advantage.

In the USA, the MAS device is deemed to be a class 2 medical device, and therefore it is necessary to have a prescription in order to obtain one. However, there is nothing whatsoever stopping a US citizen buying such a device online and importing it for their own usage on a personal basis.

By way of contrast, in other countries such as Australia, MAS devices can be bought without a prescription in any regular pharmacy or highstreet store.

Incidentally, as an alternative to using a self applied MAS device, you might like to consider trying 'Chin-Up Strips'. These strips are like an adhesive version of the MSA, except they are 'worn' externally.

You apply the strip to the lower half of your face to prevent you from breathing through your mouth, so that you cannot snore. However, the beauty of using these is that they are not likely to cause you any pain or discomfort, whilst they are very effective for forcing you to breathe through your nose, thus minimizing the possibility of you snoring.

Anyway, as a safer and a probably more effective alternative to using a self-applied MAS device, Chin-Up Strips are definitely worth considering.

Continuous Positive Airway Pressure device

A Continuous Positive Airway Pressure (or CPAP) device is one that is very similar to those that they use to keep new born babies who cannot breathe for themselves breathing. However, it is equally as effective for those who need a fairly proactive device to help them prevent snoring or sleep apnea.

This device is effectively a fairly sophisticated air blower that operates through a mask that is placed over the mouth and nostrils. Once in position the ventilator/blower forces air through the nostrils of the sleeping ‘patient’. The machine maintains air pressure at a level that is just sufficient to prevent the throat from collapsing.

Section summary

• If there is a physical reason for a patient’s snoring habit, it is possible to treat it with surgery. However, the surgery is not always successful and in some cases will make the situation worse rather than better.

• It is also possible to buy over-the-counter sprays, pills and medicines which are claimed to get rid of or at least alleviate snoring. There is some skepticism as to whether any of these medicines work.

• Having an MAS device professionally fitted by a dentist or orthodontist is sometimes effective. Over-the-counter MAS devices tend to be considerably less so.

• CPAP can also help, but are really only likely to be used for the most chronic cases.

• All of these solutions might work. However, they should all be last resorts, only to be considered after you try all of the natural remedies highlighted later.