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Where There's Heat, There's Light Snoring

Heat-induced scars stiffen palate to soften snoring, says new study

FRIDAY, Oct. 12, 2001 (HealthDayNews) -- A new technique to attack the cause of simple snoring noise may give your bedmate an easier night's sleep, says new research from North Carolina.

"The scope of the problem is enormous," says Dr. Todd Kingdom, assistant professor of otolaryngology/head and neck surgery at Emory University School of Medicine in Atlanta, Ga. "Small estimates have more than 40 percent of people snoring. That's millions and millions of people."

A new study from the University of North Carolina at Chapel Hill School of Medicine reports that the technique, which uses radiofrequency energy, is turning down the volume on habitual snoring with a lot less pain and fewer relapses than other treatments. The findings were published in a recent issue of the Archives of Otolaryngology Head and Neck Surgery.

When you snore, the soft palate in the roof of your mouth vibrates. To stop that vibration, doctors give a patient local anesthesia, then insert a small needle heated by radiofrequency energy into the soft palate and down into the muscle. The heat creates a sore that tightens the tissue and cuts down on the vibrations that produce snoring.

Those who have the procedure usually go back to work the next day, taking Tylenol or Motrin for pain. Laser surgery, on the other hand, generally requires a week off from work and 10 days of narcotic pain relievers.

"All the injury is underneath the lining, so there's no scar, no scab and no raw space," says Dr. Wendell G. Yarbrough, assistant professor in UNC's department of otolaryngology/head and neck surgery. "But it still creates the scarring to make the palate stiffer."

At first, doctors did one wound at a time, having patients return for more until their snoring abated.

"That's kind of unacceptable," Yarbrough says. "People don't want to go to the doctor that many times."

Yarbrough and his colleagues now create several lesions at the same time. The more energy used and the more lesions done in one session, the higher the cure rate, with "cure" defined as a bed partner who isn't bothered by the noise.

Twenty-five percent of patients who got one lesion at a time were cured after two treatments. With two lesions at a time, the two-treatment cure rate is 71 percent. After 18 months, the patients still had less snoring.

"Now, we're starting to give five lesions," Yarbrough says. "It does seem the more energy you give and the more lesions, the less treatment sessions they have to come back for."

Yarbrough says patients haven't reported any change in their voice or swallowing, although about 5 percent of patients will say they feel "a little different."

Doctors at Emory University have used the same procedure for several years, and found similar results.

"This is amazingly well tolerated," Kingdom says. "They can go back to work the next day or even the same afternoon, and I haven't had anyone turn down a subsequent treatment because of pain."

Yarbrough and Kingdom emphasize that the procedure only helps people with simple snoring. It doesn't work for sleep apnea, a potentially serious condition in which the airway is blocked during sleep, waking sufferers up several times during the night, gasping for breath. In fact, Yarbrough's team found that the procedure actually made sleep apnea worse.

Because snoring is the classic symptom of sleep apnea, Kingdom says he requires a thorough evaluation before the procedure is done.

"I don't do this procedure on anyone who hasn't had a sleep study," he says. "You could miss a more serious problem."

For those who are good candidates, Yarbrough says the procedure is a safer and much less painful way to lessen a real source of irritation in their lives.

"Our goal is to make it nicer for patients," he says. "If you can decrease the comfort and the cost and make it just as or more efficacious, that's good for everybody."

What To Do

For information on normal breathing, snoring and sleep apnea, check out the Academy of Dental Sleep Medicine. For a clear look at the geography of your mouth and which parts are the problems, check out this diagram at the American Academy of Otolaryngology.

Here are some tips to help your snoring, and here's how to tell the difference between simple snoring and sleep apnea.

SOURCES: Interviews with Wendell G. Yarbrough, M.D., assistant professor, department of otolaryngology/head and neck surgery, University of North Carolina at Chapel Hill School of Medicine; Todd Kingdom, M.D., assistant professor of otolaryngology/head and neck surgery, Emory University School of Medicine; Sept. 10, 2001, Archives of Otolaryngology Head and Neck Surgery
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