Snoring Causes & Solutions
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Introduction This educational booklet is written for people who suffer from sleep disordered breathing and their sleeping partners. It can also be used for discussion with your health care provider. In the following pages, you will discover a simple overview of sleep disordered breathing. To find your solution, it’s good to have a basic understanding of causes of snoring and the range of sleep disordered breathing. The great news is that snoring can be tamed and your life can be improved overnight. There is no single treatment that works for everyone. But everyone CAN find a solution that works for them. Most treatments in this booklet can be used to successfully treat the entire range of sleep disordered breathing. Whether you find your solution with the Dentist, the Physician or SnoreMart.com, your life will be improved.
Warmest regards,
Patrick Tessier, MBA Founder of SnoreMart
Disclaimer: This guide is not intended to be a substitute for professional medical advice, prevention, diagnosis or treatment. Always seek the advice of your physician or other qualified health providers with any questions regarding a medical condition.
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Snoring Causes Snoring is very common, with about half the adult population snoring at least occasionally. In fact, it is difficult to find people not affected by snoring. Almost everyone has a story to share. There are many serious negative effects associated with snoring ranging from sleep deprivation for the partner to obstructive sleep apnea for the snorer.
Causes of Snoring Snoring is the harsh sound you hear when the snorer inhales during sleep. Air travels past the soft, flexible structures such as the palate, uvula, tonsils and tongue. When sleeping, the soft tissues at the back of the throat relax, the jaw and the attached tongue fall back and the airway is significantly more narrow. As air goes through this narrow passage, pressure and velocity increase, causing the tissues to vibrate.
Normal Breathing
Snoring
Sleep Apnea (OSA)
No Blockage
Partial Blockage
Complete Blockage
There are many factors that affect snoring including: • • • •
Sleeping position Nasal congestion Enlarged throat tissues Small lower jaw
• • • •
Obesity Muscle relaxers & Alcohol Smoking & throat irritants Mouth breathing
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Snoring Causes Sleep Disordered Breathing Sleep disordered breathing is the medical term for anything from simple snoring to severe obstructive sleep apnea. As the condition becomes worse, it can cross the line from simple snoring to obstructive sleep apnea. As many as 90 million Americans snore occasionally. It is estimated that less than 2 million suffer severe sleep apnea.
Sleep Disordered Breathing Snoring
Obstructive Sleep Apnea
90 million
Occasional Snoring
Regular Snoring AHI: < 5
Upper Airway Resistance Syndrome
Mild Sleep Apnea
Moderate Sleep Apnea
Severe Sleep Apnea
AHI: 5-15
AHI: 15-30
AHI: > 30
Sleep apnea can also be present in the form of Central sleep apnea or a hybrid of both central and obstructive sleep apnea. Central sleep apnea originates in the brain, which fails to send proper signals to the breathing muscles.
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Snoring Causes Snoring vs. Obstructive Sleep Apnea Sleep Disordered Breathing is broken down in two categories: snoring and obstructive sleep apnea. Then further categorized into three major sub-groups. These sub-groups are defined by the Apneaâ&#x20AC;&#x201C;Hypopnea Index (AHI). AHI is measured with a home sleep test (HST) or a Laboratory sleep study (PSG) Apnea event Hypopnea event AHI
= 80-100% reduction in airflow with stoppage of breathing for 10 seconds or more. = 50-80% reduction of airflow with stoppage of breathing for 10 seconds or more. = (Number of apnea + hypopnea events) / hour
Snoring Benign snoring is not considered a medical condition, but it is the cause of serious negative health issues from sleep deprivation to marital discord. Treatment to eliminate snoring can have numerous benefits.
Snoring ..................... < 5 AHI Obstructive Sleep Apnea (OSA) OSA is a medical condition that can shorten your life. It has many related serious health issues. OSA is supported by most medical insurances and several branches of the medical community, including Dentistry.
Mild............................. 5-15 AHI Moderate...............15-30 AHI Severe....................... > 30 AHI
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Sleep Testing There are a number of testing options available to gain insight to your condition. Below are the simple tests to get you started.
SnoreLab For the snorer in denial, record them with this innovative app for an iPhone. Nothing like the embarrassment of hearing yourself snore to provoke action!
Questionnaires Three short quizzes can start your discovery process: STOPBang, Epworth and Berlin questionnaires.
STOP-BANG Sleep Apnea Questionnaire Chung F et al Anesthesiology 2008 and BJA 2012
STOP Do you SNORE loudly (louder than talking or loud enough to be heard through closed doors)?
Yes
No
Do you often feel TIRED, fatigued, or sleepy during daytime?
Yes
No
Has anyone OBSERVED you stop breathing during your sleep?
Yes
No
Do you have or are you being treated for high blood PRESSURE?
Yes
No
BMI more than 35kg/m2?
Yes
No
AGE over 50 years old?
Yes
No
NECK circumference > 16 inches (40cm)?
Yes
No
GENDER: Male?
Yes
No
BANG
TOTAL SCORE
Number of Yes answers : Risk of Obstructive Sleep Apnea 0-2 : Low 3-4: Intermediate 5-8: High
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Sleep Testing Home sleep testing can be used for informational and diagnostic purposes. They are accepted by health care providers and actually preferred by most insurance companies.
Home Sleep Testing - Private Professional sleep testing from the comfort of your own bed. Inexpensive, accurate 2 night study using a type III device. Interpreted by a board certified MD. Results are private, only sent to you.
Home Sleep Testing - Insurance Get financial help from your medical insurance for this world class HST. Record for 2 nights to get an accurate test result. Interpreted by a board certified MD. We do all the paperwork.
Laboratory Sleep Testing (PSG) A supervised overnight sleep test is the gold standard for a variety of sleep disorders. Qualified technicians insure the data collected is accurate. Results are read and interpreted by a board certified MD. This is also know as polysomnogram testing or PSG.
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Treatment Overview This guide groups the available treatments by the intended results, all of which are documented to reduce or eliminate sleep disordered breathing symptoms. Most treatments can be effective for the entire range of sleep disordered breathing, from snoring to obstructive sleep apnea.
Lifestyle Changes
Eliminate the Noise
Weight Loss Bariatric Surgery (Lap Band) Stop Smoking Avoid Alcohol or Muscle relaxers
Open the Nose Nose Dilators Chin Straps Reduce Nasal Congestion nasent Classic Winx Sleep Therapy System Septoplasty Surgery
Donâ&#x20AC;&#x2122;t Sleep on the Back Mechanical Devices Tennis Ball - Free SlumberBump Remetee Bumper Belt Zzoma Belt Anti-Snore Pillows Electronic Devices iRollover Night Shift NightBalance
Sleep in different rooms Cover-up with Therapeutic Noise Ear Plugs
Tighten the Throat Throat Exercise Homeopathic Astringents
Open the Airway Chin Straps Oral Appliances Tongue Retention Device Non-Custom Oral Appliances Custom Oral Appliances EPAP CPAP Surgical Pillar Procedure SomnoPlasty (Radio Frequency) UPPP Uvulopalatopharyngoplasty TransOral Robotic Surgery Tracheostomy Inspire Upper Airway Stimulation Jaw Repositioning (Oral Surgery)
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Lifestyle Changes Weight Loss The #1 most effective treatment. A popular medical solution is Bariatric Surgery - (Lap Band)
Stop Smoking Smoke irritates and inflames the tissue in the throat, shrinking the airway and contributing to snoring.
Avoid Alcohol or Muscle Relaxers Drinking before bed will relax the throat muscles and almost always contribute to snoring. Ask a camper.
Eliminate the Noise Sleep in Different Rooms 25% of married couples end up sleeping separately. Just ask Tom Cruise or Judge Judy. They built â&#x20AC;&#x153;snoratoriumsâ&#x20AC;?.
Cover with Therapeutic Noise Sound therapy using a special sound machines invoking soothing sounds from nature are great.
Ear Plugs Simple and effective. Foam or silicone ear plugs lower the decibels in the room & allow you to get some sleep.
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Tighten the Throat Throat Exercises Strengthen the throat muscles reduces tissue size. Playing the didgeridoo is a proven solution.
Homeopathic Astringents Herbal based astringents have been documented to shrink tissue since the 1300s. Still works today.
Open the Nose Nasal Dilators More effective than nose strips, these devices open the nasal passage from the inside. Amazing results! Available in S/M/L
Chin Straps Simple and effective. By keeping your mouth closed, you are forced to breathe through your nose.
nastent Classic nastentâ&#x201E;˘ is a soft, tube-shaped medical device that is inserted from the nose to the uvula. Simple and effective.
Winx Sleep Therapy System This device creates a negative pressure in the oral cavity, which opens the airway for nasal breathing.
Septoplasty Surgery Corrective surgery for a deviated septum. Opens the nasal passage permanently.
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Don’t Sleep on the Back Tennis Ball Cheap, quick and super effective. Tape a ball on the back of a tee shirt. (see the free video on www.SnoreMart.com)
SlumberBump Designed by a Utah Dentist, this device comes in two sizes and even has an extention belt available.
Remetee Bumper Belt A big step up from the tennis ball solution. Designed in Canada and comes in S/M/L/XL
Zzoma Belt Developed by a Doctor, this one-size-fits-all belt produces documented results.
Anti-Snore Pillows Built to encourage side sleeping, these comfortable pillows come is several designs
iRollover Developed in a Chicago Sleep Lab, plays your recording to encourage your sleeping partner to “ROLL OVER”
Night Shift Worn on the back of the neck, Night Shift vibrates when you start to back-sleep. Clinically validated
NightBalance Active sleep position sensor which trains patients using gentle vibrations to not sleep on their back.
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Open the Airway Oral Appliances The American Academy of Sleep Medicine (AASM) recommends oral appliances as the first line of therapy for the entire range of sleep disordered breathing, except severe sleep apnea.
Tongue Retention Device This device is placed in front of the teeth and the tongue is retained in the little bulb. It is recommended for people that experience jaw pain (TMJ) or do not have a full set of healthy teeth (Wear full / partial dentures or have loose teeth).
Non-Custom Oral Appliance The single most popular snore prevention product. These inexpensive devices work much the same as a custom device. SnoreRx and SnoreMD are adjustable and use a heat molded fitting process. ZQuiet can be used right out of the box.
Custom Oral Appliance Most professionals and patients alike consider a custom oral appliance to be the best treatment for the largest range of sleep disordered breathing. Obtained from a Dentist with advanced training in Dental Sleep Medicine. They fit perfectly and are long lasting. With over 100 products available, you have some choices. Your Dentist will know which is the best for you. In addition to Dental Laboratory fabricated devices, your Dentist can also build a short term device right in the practice for a much reduced cost. These devices are best for snoring through moderate OSA. To find a Dentist near you:
www.SnoreMart.com/doctor
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Open the Airway EPAP Expiratory Positive Airway Pressure is a new treatment protocol developed at Stanford University. As you breathe in, the patented MicroValve Technology opens, allowing you to breathe in normally. As you breathe out, the MicroValves close to create a gentle pressure that naturally opens your nasal airway and relieves snoring. Comes in two versions: Theravent from SnoreMart or ProVent from your health care provider. Both versions involve covering your nose with the small valve device.
CPAP CPAP, which stands for Continuous Positive Airway Pressure was developed in the 1980s. It is a pneumatic splint for the nasopharyngeal airway. It is absolutely the gold standard for treating obstructive sleep apnea. CPAP has come a long ways since the 1980s, but the fundamental design is consistent. Other versions include: BiPAP - which varies the pressure breathing in and out AutoPAP - Which automatically adjusts the pressure for you. There are a variety of masks to improve comfort. Nasal pillows are popular. You can also add humidifiers. The biggest downside is wearing the mask. In fact, 40% of patients prescribed CPAP therapy end up refusing the treatment. If you have been diagnosed with severe obstructive sleep apnea, itâ&#x20AC;&#x2122;s a life saver.
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Open the Airway The following is a list of the most common surgical procedures.
PIllar Procedure In about 20 mins, under local anesthetic, a doctor uses a sterile device to place 3-5 tiny implants to support & stiffen the palate.
SomnoPlasty Under local anesthetic, the doctor uses a small electrode to deliver RF energy under the target tissue. After 6-8 weeks, the healing process shrinks and stiffens the tissue.
Uvulopalatopharyngoplasty (UPPP) A common procedure involves removal of tissue in the throat. Typically removes the tonsils and surfaces of the soft palate and uvula.
Transoral Robotic Surgery (Tors Bot) Minimally invasive robotic surgery using a da Vinci surgical robot machine. Uses a high-definition, magnified camera for precise surgery at the base of the tongue (BOT).
Tracheostomy One of the oldest procedures, it consists of inserting a tube to serve as the airway. This is a life saver in extreme cases.
Inspire Upper Airway Stimulation Completely implanted, it continuously monitors your breathing patterns. Delivers mild stimulation to key airway muscles.
Jaw Repositioning Surgery Maxillomandibular advancement or BiMax permanently moves the upper and lower jaw forward with oral surgery.
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For More Information You can obtain more information regarding sleep disordered breathing and treatments from the following web sites American Academy of Dental Sleep Medicine www.aadsm.org American Academy of Sleep Medicine www.aasmnet.org American Sleep Apnea Association www.sleepapnea.org National Sleep Foundation www.sleepfoundation.org American Academy of Craniofacial Pain www.aacfp.org
For comments or questions regarding information in this booklet SnoreMart, Inc. 877-252-7317 support@snoremart.com www.snoremart.com
Personalized reprints for Professionals can be obtained from SnoreMart patrick@snoremart.com 425-250-6290 Š 2015- SnoreMart Inc. All rights reserved. No part of this booklet may be reproduced in any manner without written permission from SnoreMart, Inc.
877-252-7317
The Superstore for Everything Snore
www.SnoreMart.com