In this article I am going to be talking about a few types of stop snoring surgery. I will also describe how each of the surgery works and lastly I would mention which surgery are covered by insurance. Before I continue, I would like to define snoring. Why is this needed you ask? This is because what seems to be snoring might also be a case of sleep apnea, which need/requires different kinds of surgery and cure. Snoring is defined as the sound of the vibration against or soft palate or the soft tissue in your airway. Sleep apnea is the repeated blockage of your airways throughout the night, leaving you gasping for breath. (often unconsciously) Of course, a sleep apnea patient may not even snore and a snoring patient may not have sleep apnea. It is just useful to know which one is the underlying cause, so proper surgery can be conducted.
There are also cases where people only snore when their nose are blocked. They have to breath through their mouth, and this causes snoring to happen. In this case, they need a totally different surgery. You might have a deviated septum or a blocked nasal passage. Of course, there are practically hundreds of causes for snoring including drinking alcohol and obesity. (You can even snore because you are sleeping on your back instead of your side!) Your doctor might perform a sleep study and an in depth analysis of your situation to know the cause of your snoring . It is helpful and even mandatory to thoroughly find out the cause of your snoring before a doctor or sleep specialist can proceed with a surgery recommendation. With that in mind, let’s move on to a list of popular surgery.
Most of the surgery described below can be done at your physician’s office using local anesthetic. (only the area affected is being injected with anesthetic, in other words you are not sleeping like a log) This is a fairly critical point because a general anesthetic can be dangerous to those suffering from sleep apnea. No doctors worth his or her degree are going to perform a general anesthetic on you while fully aware that you have sleep apnea. This is because of the effect general anesthetic can have on your airways.
Onwards.
The first snore surgery I’m going to be talking about a laser snoring surgery called the laser-assisted uvulopalatoplasty or LAUP to make it easy. (never know why the procedure must be in Greek!) It is a modified version of the uvulopalatopharyngoplasty (UPPP) surgery but less invasive. Like the name suggests, LAUP uses a laser to perform the surgery. Your physician will use a laser to cut the uvula and tighten any loose tissue by scarring it. (uva means grapes in greek, that is why they sound greek!) Uvula is the hanging tissue at the back of your mouth. Like I said above, snoring is caused by the vibration of air against your soft tissue. The reason why it vibrates is because your airways is small. (Various reasons like obesity can collapse your airways) So by cutting off your uvula, you will have bigger airways that have one less soft tissue to vibrate against. However, the success a laser surgery for snoring is not guaranteed. You might still snore even after the laser surgery. It is the same case with sleep apnea (this surgery is even used to treat sleep apnea) and more than one session is required. If you do not want to have multiple (3-5 visits over several months) session, you might want to choose to have a UPPP since you can have everything done within one session.
The UPPP has been reported to be effective short term. However, after a year, only half of the patient reported that snoring has stopped entirely or at least markedly improved. As for LAUP, a study of 741 patients reveal that the snoring problem returns after 18 to 24 months of performing LAUP. This is disturbing because only 55% of the partner is reported to be satisfied with the procedure. 12% of the 741 patient even reported that their snoring problem got worse than before the LAUP surgery! This might be because of the inflexible soft tissue due to the scarring.
If you are afraid of pain, you should not do the LAUP and especially the UPPP. Another less painful alternative is called the Cautery Assisted Uvulopalatoplasty. (CAUP) This snore surgery uses cautery equipment. The doctor uses a heated wire or electrode to burn off the uvula. The effectiveness is the same with LAUP and UPPP anyway.
Another relatively new surgery on the block is called Somnoplasty or Radio Frequency Tissue Ablation. (RFTA) It is approved by the Food and Drugs Administration (FDA) in July 1997. Unlike the LAUP which uses a laser to cut the uvula, the modus operandi of RFTA or Somnoplasty is to shrink the uvula using radio frequency. A needle is pierced through your tongue, throat or soft palate. The needle is connected to a radio frequency generator which heated the needle to 158-178 degress. Your inner tissue will shrink, but your outer tissue is left intact so you still have your taste bud. The procedure will take about 30 minutes, and you need to go for RFTA for more than one session for it to work. But you do not have any guarantee whether it will work or not either. Compared to LAUP, RFTA is relatively new and does not have proof that it works. There is no peer-to-peer paper published on the effectiveness of RFTA surgery for snoring (or lack of) yet.
However, the brochure for RFTA or Somnoplasty claims that:
- You will have 85.3% success rate after just two Somnoplasty treatment.
- Reduce mean snoring index by 60%. I think this means your snoring noise will reduce by 60% or maybe your snoring frequency will reduce by 60%.
- Reduce mean Epworth Sleepiness Score by 37.5%. This means you will be less likely to doze off or fall asleep while doing various activities measured by the Epworth Sleepiness Index.
- Cure both snoring and sleep apnea.
The next popular snoring surgery is called the Coblation-Channeling. (If this sounds new agey, do not worry because it is not some whack job. It is approved by the FDA in February, 2000) This snore surgery is even newer than RFTA, and thus have even less data. The RFTA also does not have any peer to peer reviewed journal on it yet. Like RFTA, it uses radio frequency to shrink your uvula and you need to have multiple sessions too. (No one time silver-bullet here)
The next snoring surgery is for both snoring problems and Obstructive Sleep Apnea. (OSA) It is also approved by the FDA, in the year 1998. It is known as the tongue suspension procedure or Repose. This snore surgery is designed to prevent your tongue from falling back in your throat/airways so that it will not block your airways. This is done by having small screws inserted into your lower jaw bone and stitching your the back of your tongue to prevent it from falling backwards. Now this sounds uncomfortable, so fortunately this procedure is reversible. This snore surgery, however is not a one stop surgery. You will need to perform other kinds of snore surgery in order for it to work. Unfortunately, the Repose procedure does not have any clinical evidence that it works.
Genioglossus Tongue Advancement surgery is another alternative to the Repose surgery. Genioglossus is the muscle which keeps your tongue forward and prevents it from falling backwards into your throat. (Blocking the air) The Genioglossus Tongue Advancement snoring surgery is done by pulling the tiny bone connected to your Genioglossus muscle. This is done by using a tiny screw (Inserted into your jaw bone) to hold the tiny bone that is connected to your Genioglossus muscle. The screw can be removed 2 months later if you wish.
You can have the tonsillectomy done to improve your chances of curing your snoring problems. Your tonsils are removed so that your airways is bigger. In the case of snoring, the bigger your airway is the better it is. All the snore surgery I know of is designed to either cut away loose soft tissue or to enlarge the airways. This is the same with any other alternative “cures” that exist on the Internet. To further enlarge your airways, you can also do a procedure called Cautery Assisted Palatal Stiffening Operation. (CAPSO) Like the CAUP procedure above, the surgeon will use an electrocautery equipment. But instead of the uvula, the surgeon will remove your soft palate. (the soft tissue above your tongue) The CAPSO procedure has been proven to be successful 92% of the time in the short term and 77% success rate after 12 months. (click here to read the study on the CAPSO procedure)
There is a new and non-invasive snoring surgery to harden your soft palate. (so that it will not vibrate) It is called the pillar procedure. This procedure does not require the doctor to cut or burn away any soft palate tissue. It is relatively painless and can be done in 20 minutes using just local anesthetic. Did I get your interest yet? If not, get this, 80% of the bed partner is reported to be satisfied with the snoring reducing. 80% of the patient also shows a reduction in their Apnea Hypopnea Index level. (AHI, which measures the number of apneas and hypopneas that occur during sleep) And best of all, it works for both snoring and sleep apnea problem too.
Now that I have your attention I will explain how the Pillar procedure works. Tiny woven implants are inserted into the muscle of your soft palate. The pillar implants are about 18 mm (0.7 inces) in length and has a diameter of approximately 2 mm. (0.08 inches) These are very small, so they do not interfere with your eating, talking and breathing. You will not even feel the presence of the implants. The Pillar implants are made from polyester which has been used for 50 years in the medical industry for most implants product. It works by stiffening your soft palate. This will reduce vibrations of the soft palate significantly. Now this is important because of the most common reason why people snore is because of loose tissue.
All the above surgery is, unfortunately, no covered by the insurance company because it is considered a cosmetic surgery. (Outrageous, I know)
This concludes the surgery for those who are snoring because of blocked mouth airways. However if you are snoring because of nasal congestion, a different snoring surgery is required. Here is the good news. This surgery is covered by the insurance company because it improves your breathing during the day. The surgery your physician will most likely recommend you do is a nasal surgery or a deviated septum surgery. Your doctor might even use radio frequency to decrease the size of your nose’s turbines so that the nose airway is bigger and clear from any obstruction. The chances of you getting rid of your snoring problem are extremely high if the sole cause of your snoring problem is nasal congestion.
Sure, you can use various sprays or pills to clear your nasal pathway but it will not be effective if your problem is deviated nasal septum. This will need a deviated septum surgery known as septoplasty for sure. The nasal septum is the soft cartilage wall dividing your left and right nose. It is covered with skin and is supposed to be in the middle. Some of the time, it is not in the middle and this blocks your nose. Worse, the drainage of the sinuses is blocked and this will cause even more blockage and possibly infection. All this causes you to breath through your mouth and loud snoring follows. Sometimes, it will not be the fault of a deviated septum but something called the nasal polyps. This is a condition where benign growths develop in your sinuses and blocks your airways. Small nasal polyps can be cured fairly easily by using a corticosteroid nasal spray. If it is a big nasal Polyps growth; however, you will need to undergo a surgery called Endoscopic sinus surgery.
Another kind of surgery is the lower jaw advancing surgery. This is done to free your airways from obstruction. Because your tongue is connected to the lower jaw, (called mandible) a lower jaw advancing surgery can prevent the tongue for blocking your airways when it falls back in your mouth. Another invasive surgery that has an extremely high success rate is the tracheostomy procedure. It is the direct opening of the wind pipe, and it relieves both snoring and sleep apnea problem. It is one of the last-resort surgery that most people will not reach. So do not worry about it too much.
Of course, you must consult with your doctor on the surgery that are suitable for your anatomy and insist on asking the risk involved. You can even do your own research on the recommended snore surgery. See if the procedure has been proven to work in a peer to peer reviewed journal (which means other surgeons are able to perform or duplicate the success of the surgery) journal. Make sure the case are similar to yours and get a second opinion just to make sure.
Of course, there is a lot of other alternatives besides a snore surgery. You can ask your sleep specialist for advice and alternatives. I will list down some of them here. Other alternatives are snore guards, snore spray, CPAP machine (for apnea sufferer but with only 40% effectiveness) and herbs. I also advise you to find a specialist for opinion as they might know some new leading edge treatments that a General Practitioner (GP) has no knowledge. Normally, the specialist is called otolaryngologists, (They specialist in nose, ear and throat) oral surgeon and maxillofacial surgeon.
Now you might be wondering if all the above surgery hurts. It hurts like HELL after you have done the surgery and chances are you cannot even talk because of the pain. This is of course, depending on which surgery you are going to take. Some surgery will not hurt as much as others. And it will most likely hurt more if you combine more snoring surgery. After 24 hours, you will most likely feel a lot better and can talk almost without pain. For the next 1 week, you will feel little pain and you can function normally for most of the time. (Talking and eating will feel less than normal and a little bit of pain is to be expected) After two weeks you should be fully healed and feel no pain whatsoever. Of course, this is different for everyone and depends on what kind of surgeries you take.