Snoring is actually a noisy breathing pattern that disturbs your spouse, your friend, and those around you. Snoring without sleep apnea is a social problem. During sleep, it occurs when the moving tissues (soft palate, uvula) vibrate as the air you breathe passes through narrowed areas through the upper respiratory tract.
Sleep. The fact that it is accompanied by apnea makes medical treatment essential. Sleep Apnea; It is the sudden and temporary stopping of breathing during sleep due to stenosis in anatomical areas that tend to narrow the upper respiratory tract, such as the soft palate, base of the tongue, and back of the nasal passages. Breath stoppage may be short or long lasting. The person cannot remember this situation. As a result of this;
- Not being able to sleep
- Fatigue
- Dizziness that lasts until the next day
- Headache
- Memory and concentration impairment
- While watching television, Tendency to sleep while driving
- Increased blood pressure,
- Heart rhythm disorders occur. Especially sleep apnea is a life-threatening disease that needs to be treated. The essence of the treatment is to change the person's lifestyle.
IMPORTANCE OF BREATHING IN SLEEP
The air we breathe is in the upper respiratory tract. On its way, it passes through soft moving tissues as it heads from the nose to the lungs. These structures are the tonsils, the base of the tongue, the small tongue, and the soft palate. The airway, which is kept tense by the muscles during the day, narrows and collapses inward as these muscles relax during sleep.
If these tissues - soft palate, tonsils, epiglottis or tongue root – if they are large, the tissues vibrate as the inhaled air passes through your throat, snoring occurs and it becomes difficult to transmit air to the lungs, causing sudden respiratory arrest. If these tissues in your throat grow excessively and narrow the airflow almost completely, the airflow decreases greatly, this situation occurs during certain periods of sleep. It is called "what".
The more frequent and longer the apnea, the lower the oxygen level in the blood. Our brain reacts to this situation by waking up suddenly and tightening the muscles, and the respiratory tract opens again. This event is repeated many times during the night, the person does not remember this situation despite waking up, and a poor quality unhealthy sleep pattern develops.
Nasal bone curvature, nasal contusions, polyps. , adenoid enlargement may cause snoring and low-level sleep apnea. Allergies, infections and cigarette smoke also cause edema of the tissues, which paves the way for snoring – apnea
SNORING AND SLEEP APNEA SURGERY
For sleep apnea and snoring patients We can categorize surgical interventions for nasal congestion in three groups.
Surgical interventions for relieving nasal congestion
If there is bone curvature (deviation), nasal flesh growths (turbinate hypertrophy), polyps in the inner compartment of the nose. If it causes nasal congestion and causes snoring-sleep apnea, the nasal congestion must be removed by surgical methods. For this purpose, we can perform nose interventions under general anesthesia. Correcting the bone curvature, applying radiofrequency to the nasal concha, or removing polyps with FESS can correct apneas. Studies have shown that the rate of apnea patients due to nasal congestion alone is approximately 4% of all respiratory arrest (apnea) patients. For this reason, a single intervention performed only on the nose may not provide much benefit in patients with moderate to severe apnea. In such cases, nose surgeries are combined with other methods.
Surgical interventions for the soft palate
The most frequently performed surgical intervention for the soft palate is UPPP (uvulapalatopharyngoplasty). ) is. With this surgery, all tissues that narrow the oral cavity and airway (tonsils, soft palate, uvula) are opened by intervention. It is performed under general anesthesia. If only the soft palate is treated using laser, this surgery is called LAUP. Its difference from UPPP is that it can be performed under local anesthesia even in office conditions. With another initiative, radiofrequency By using s, the soft palate is made smaller and tense. My personal opinion is that radiofrequency (RFA) can be used in simple snoring cases, but is not effective in the presence of moderate and severe apnea. The soft palate is made tense with radiofrequency energy.
Surgical interventions on the base of the tongue and the larynx
The most frequently performed surgery performed under general anesthesia is sleep-in. Surgical suture material passed through both tongue roots is fixed to the lower jaw bone, thus the tongue base is pulled forward and the narrowed air passage is opened. There are severe cases that require Sleep to be performed together with other surgeries. In cases where there is excessive tissue excess at the base of the tongue, some of the soft tissue is surgically removed. The basic philosophy of all these surgical approaches is to eliminate the causes that narrow the air passage. It is beneficial to consider each patient individually and make surgical planning individually.
In case of problems involving the jawbone, lower jaw advancement (bringing forward) attempts are performed. If the lower jawbone is positioned behind, skeletal correction should be made. This surgery, called mandibular advancement surgery, is a very difficult surgical intervention for the patient.
Some complications, although rare, may develop after all surgeries. Bleeding, inflammation, a feeling of stuckness in the throat, and water and food passing through the nose are undesirable consequences. Soft, liquid foods should be consumed for a while, especially after interventions on the base of the tongue and soft palate. It is important for you to have regular follow-ups after surgery. You may need to have a control sleep test 6 months after the surgery to evaluate the result of the surgery.
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