No snoozing through the night

I am a newly married modern Orthodox woman. My husband, 28, is of normal weight and healthy. Since we got married, I found that he is a heavy snorer, and the noise often keeps me up late at night. He does not suffer from sleep apnea; I have been listening to his breathing when he sleeps to find out whether he stops breathing momentarily (apnea), but I haven't noticed this. I was wondering if there is any medical or other treatment to reduce or eliminate his snoring. E.J., Rehovot Dr. Anat Shatz, an ear, nose and throat surgeon in the pediatric airway service at Jerusalem's Shaare Zedek Medical Center, comments: It's recommended to see an ear, nose and throat specialist. Snoring is an indication of obstructed breathing. Therefore, it should be taken seriously. The noisy sounds of snoring occur when there is an obstruction to the free flow of air through the upper airways, especially at the collapsible region at the back of the pharynx (lower part of the throat), which vibrates during breathing. Heavy snorers should seek medical advice to ensure that snoring is not associated with sleep apnea. An ENT surgeon will provide a thorough examination of the nose, mouth, pharynx, throat, palate and neck. An examination may reveal if the snoring is caused by nasal allergy, infection, deformity, tonsils and adenoids or by other causes. In some cases, heavy snorers should be examined at a sleep lab or hooked up to sensors at home to determine how serious the snoring is and to rule out sleep apnea and other effects the snoring may have on the snorer's health, such as blood-oxygen level and blood pressure. Treatment depends on the diagnosis. Snoring or obstructive sleep apnea may respond to various treatments now offered by ENT surgeons. Treatment may be conservative or involve surgery. Allergy with stuffiness of the nose can be treated medically. Snoring may be a sign of obstruction by the tonsils and adenoids; tonsillectomy and adenoidectomy may be required (especially in children). With severe deviation of the nasal septum, a septoplasty (a surgical procedure to correct a deviated nasal septum, which is a displacement of the bone and cartilage that divides the two nostrils; in such a procedure, the nasal septum is straightened and repositioned in the middle of the nose) may be performed. When the problem is a collapse of the airways at the lower pharynx and the back of the tongue, the patient may sleep every night with a continuous positive airway pressure nasal mask, which delivers air at high pressure into the throat. Other surgical procedures for the prevention of collapsed airways that cause snoring and sleep apnea may include pulling the tongue muscles forward, thereby opening the obstructed airway. The procedure is called genioglossus and hyoid advancement, in which the hyoid bone and its muscle attachments to the tongue and airway are pulled forward to increase airway size and improving airway stability behind and below the base of the tongue. Other procedures may also be offered, depending on the underlying cause. In the August 28 issue of the Magazine a reader queried the benefits of using a particular brand of hard lens, called Ortho K, while asleep to improve her vision, instead of undergoing Lasik surgery. Dr. David Varssano, director of the cornea and external disease service at Tel Aviv Sourasky Medical Center, confirmed that such hard lenses work, but he cautioned of rare and possibly irreversible complications. However, Prof. Kenneth Koslowe, a faculty member of Bar-Ilan University's department of optometry and of the optometry department of the Hadassah Academic College, here provides his own views. Overnight Ortho K, or corneal reshaping therapy, was developed in the early 1990s and involves the overnight wearing of contact lenses in order to reduce or remove nearsightedness (myopia). When fitted by professionals, it has proven to be effective and safe with minor complications that are similar to those found with wearing regular rigid (hard) contact lenses. The upper level of treatment today is about -7.00 diopters. The treatment is temporary in that it lasts only as long as the patient continues wearing the lenses at night. However, a major advantage over Lasik is if the patient is tired of or unsatisfied with the treatment, it is totally reversible. Stop wearing the lenses and you return to your original state. Refractive surgery such as Lasik is never reversible. As with any contact lenses, periodic checkups by your eye-care professional are mandatory. An additional benefit has been seen in recent studies in that the treatment has been shown to slow or even stop the progression of myopia. I would urge patients to select the treatment they desire, whether surgical or nonsurgical, after examining the advantages and disadvantages of each. There is also nothing wrong with wearing glasses. Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 9100002, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and place of residence.

No snoozing through the night

Snoring is an indication of obstructed breathing and should be taken seriously.

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