Sleep Disorders Current Topics in Sleep Disorders

Can a 15-Minute Procedure Stop Your Snoring?

For every husband or wife who has been driven from the bedroom as a result of his or her spouse’s snoring, there may be hope. A new treatment designed to reduce snoring seems to be effective in quieting the nighttime ruckus in a majority of patients.

The treatment, called a palatal implant, is an outpatient surgical procedure that works by stiffening the tissue in the back of the throat that is often the cause of snoring. Additionally this treatment may also be effective in treating other sleep disorders, such as sleep apnea, a condition that occurs when a person stops breathing briefly at night, causing them to wake up momentarily. These episodes can occur hundreds of times a night, seriously impacting quality of sleep.

“Snoring and sleep apnea are part of the same problem,” said Dr. Michael Friedman, lead study author and professor of otolaryngology at Rush Medical College, Chicago.

When some people sleep, the soft flesh in the back of the mouth relaxes so much it begins to vibrate with each inhale. The rushing air causes this loose tissue to vibrate, creating the low grumble or loud buzzing known as snoring.

Other forms of treatment for sleep apnea include continuous positive airway pressure (CPAP), which blows a light stream of air through the airway to keep this tissue out of the way, and surgery to remove the excess loose tissue to reduce the vibrations. However, CPAP forces a patient to wear a somewhat cumbersome mask at night and oral surgery has major risks, so these options are not always the best.

The idea behind a palatal implant is to stabilize the soft tissue in the back of the mouth, so it cannot vibrate so easily. A palatal implant consists of three tiny, rod-like inserts that are placed inside the tissue at the back of the roof of the mouth. During the procedure, only local anesthesia is needed to numb the mouth and a special tool is used to place the three rods as close together as possible. The whole process takes about 15 minutes and the patient generally can resume normal activities immediately afterwards.

Recently, researchers from St. Luke’s Medical Center, Chicago, studied how effective palatal implants are in reducing sleep apnea and snoring. The team looked at 125 patients with mild to moderate sleep apnea who had recently undergone this surgery. They found that within a few months of the procedure, 60 percent of the participants had no symptoms of sleep apnea or snoring, and about 21 percent had a reduction in their snoring and sleep apnea symptoms.

“This study demonstrated both the short and long-term efficacy of the [procedure] for the treatment of mild-to-moderate obstructive sleep apnea,” said Dr. Stale Norgrad, study author, who presented his work at the annual meeting of the American Academy of Otololaryngology-Head and Neck Surgery.

The palatal implant procedure costs around $2,000 and some insurance companies will cover a portion of this cost.

Not everyone will benefit from palatal implants, however, said Friedman. Patients who have sleep apnea because they are severely overweight will not see any improvement, because their weight is usually the primary cause of the sleep apnea. Also, in some patients, snoring is caused by tissues in other parts of the throat, so a doctor should make a careful examination before offering the implants.

“For a selected population, palatal implants have a very good success rate,” said Friedman.

And, if a patient’s snoring is not completely improved by a palatal implant, other treatments, like CPAP, may also be needed to treat sleep apnea.