Sleep Disorders

Many people suffer with sleep disorders and the most common condition is sleep apnea or obstructive sleep apnea (OSA). During sleep the upper airway becomes restricted or blocked leading to labored breathing, snoring, gasping, pauses in breathing and frequent tossing in bed. This results in sleep fragmentation and unhealthy sleep. Affected individuals feel tired, rundown, may have headaches, ‘brain fog’, sore throat and dry mouth. If this condition goes on undetected or inadequately treated, significant cardiovascular problems can develop such as high blood pressure, atrial fibrillation, heart failure and stroke. Chronic fatigue can lead to accidents and poor performance in school or at work. A sleep test at home or in a sleep lab will detect whether you have this condition and how severe it may be.

Think of the upper airway as a collapsible muscular tube attached to fixed points in the head and neck. Anything that affects airflow through this system leads to abnormal air pressures and compression or collapse of the tube. Obesity, age and anatomical obstructions are contributing factors. If you are overweight, begin an exercise program and consider a whole food plant-based (WFPB) diet. Upper airway surgery can address anatomical obstructions and significantly improve breathing not only during the day but at bedtime as well!

Procedures and Treatments

Tonsillectomy/Adenoidectomy

Enlarged tonsils and adenoids may block the middle third of the upper airway leading to snoring or contributing to obstructive sleep apnea. For many children this is the main cause of snoring and sleep disordered breathing. Children or adolescents may feel tired, ‘slow to wake up’ in the morning and be cranky or irritable due to sleep disruption. Large tonsils and adenoids are often associated with allergies. Tonsillectomy and adenoidectomy are often curative for children who suffer from this. Adults with large tonsils and adenoids also benefit from surgery.

Radiofrequency Ablation

Radiofrequency ablation or RFA of the soft tissues of the upper airway is a minimally invasive procedure done in the office under local anesthetic. A probe is placed into the soft palate, uvula, tongue or lower turbinates and a controlled amount of energy is applied. The tissues are ‘injured’ which results in a healing response over weeks resulting in tissue shrinkage and tightening.

Uvulopalatopharyngoplasty (UPPP)

That’s a mouthful! This is a surgical procedure done in the operating room under general anesthesia. Redundant tissue of the soft palate and uvula are removed. Sutures are used to tighten up the edges and create more space in the airway. The sound of snoring is mostly generated by these redundant tissues so snoring and heavy breathing sounds are significantly reduced or eliminated. Careful patient selection is very important to determine whether this is appropriate for you.

Septoplasty

A deviated septum and enlarged turbinates can restrict nasal breathing (normal respiration), which occupies the upper third of the airway. Nasal congestion and obstruction force us to open our mouth to get more air. Rapid airflow past the soft palate results in vibration and the sound of snoring. Correcting a blocked nose with septoplasty and turbinate reduction has a significant impact on breathing, snoring and sleep.

LATERA®

Two pairs of cartilages form the nasal sidewalls. Weakness of these structures causes sidewall collapse and nasal obstruction. We open our mouths to get more air during our sleep and this results in snoring and disruptive sleep for bed partners and ourselves. LATERA® is a biodegradable implant inserted into the soft tissues of the sidewalls of the nose. The implant adds rigidity to the cartilages and the sidewalls become stiffer. Over time the implant is absorbed and replaced by scar tissue that maintains sidewall integrity. LATERA® can be done with septoplasty or as a standalone procedure.

VIVAER®

This procedure is minimally invasive and performed in the office under local anesthetic. Radiofrequency energy is applied to precise areas just inside the nostrils to improve the nasal valve. As healing and remodeling occurs, the nasal valve is tightened and more resistant to collapse and nasal blockage.