Sleep Disorders

Snoring is not generally a serious condition but it can significantly impact relationships and families. When snoring is combined with other symptoms, such as daytime fatigue, morning headaches, frequent trips to the bathroom during the night and coughing/gasping/restless sleep, obstructive sleep apnea (OSA) should be considered.

The best way to evaluate OSA is to spend a night (or day) in the sleep lab at the GW Center for Sleep Disorders. Some patients who have OSA benefit from medication and/or devices, while others may need a surgical procedure to treat their conditions.

If you have troublesome snoring, possible interventions include:

• Uvulectomy: Cutting out the uvula (the small piece of soft tissue that dangles down over the back of the tongue).
• Sclerotherapy: Injecting medications to stiffen the palate and reduce soft palate vibration, which causes snoring.
• Pillar implants: Small synthetic rods are placed in your soft palate to stiffen it. The stiffening helps reduce vibration of the soft palate and may decrease or eliminate snoring.

If you have nasal congestion and snoring with or without OSA, you may benefit from:

• Septoplasty: Straightening a deviated septum (the wall that divides your left and right nostril from each other)
• Turbinate reduction: Shrinking of turbinates that block the nasal airway. These structures are in your nose and help humidify the air that you breathe, and can sometimes become too large.
• Nasal valve repair: The narrowest portion in the nose that can collapse on itself. Commercially available breathing strips can help address this problem, however some surgical procedures can offer permanent correction of this condition.
• Nasal polypectomy: A procedure to remove extra growths in the nose (typically from allergies) that can cause nasal congestion.

If you have OSA, you may benefit from any of the above and the following:

• Palatopharynoplasty (uvulopalatopharyngoplasty, z-palatopharyngoplasty, expansion palatopharyngoplasty): Modification to the soft palate to decrease vibration (snoring) and widen the airway.
• SMILE (Submucosal Minimally Invasive Lingual Excision): Endoscopic-assisted reduction of the bulk of the central portion of the tongue and the back of the tongue.
• Palate advancement: The hard palate is moved forward to bring the soft palate forward and open up the airway in the back of the throat.