Snoring is a common respiratory phenomenon occurring during sleep, characterized by a harsh sound produced when airflow is obstructed. Persistent snoring can sometimes indicate underlying health concerns. An Ear, Nose, and Throat (ENT) specialist, also known as an otolaryngologist, possesses specialized knowledge of the upper airway anatomy, making them well-suited to evaluate and address the causes of snoring.
How an ENT Diagnoses Snoring
An ENT begins the diagnostic process for snoring by reviewing a patient’s medical history. This involves gathering information about sleep habits, medical conditions, medications, and lifestyle factors such as alcohol consumption or smoking. Understanding the duration and characteristics of the snoring, including its loudness and consistency, helps the ENT form an initial assessment.
Following the historical review, the ENT performs a physical examination of the patient’s upper airway. This includes inspecting nasal passages for issues like a deviated septum or enlarged turbinates, which can impede airflow. The ENT also examines the mouth and throat, assessing the size and position of the soft palate, tonsils, and tongue, as these structures can contribute to airway narrowing.
An ENT may recommend a sleep study to investigate the cause of snoring, especially when sleep apnea is suspected. Polysomnography, a comprehensive sleep study, monitors brain activity, breathing patterns, heart rate, and oxygen levels. Home sleep apnea tests offer a convenient alternative, measuring breathing and oxygen saturation. The ENT interprets these results to determine the presence and severity of sleep apnea, guiding treatment.
Non-Surgical Interventions from an ENT
An ENT often recommends non-surgical interventions to alleviate airway obstruction. Continuous Positive Airway Pressure (CPAP) therapy, delivered through a mask worn during sleep, is a widely used treatment. This device provides constant air pressure, which acts as an air splint to keep the upper airway open and prevent collapse, effectively reducing snoring and associated breathing disruptions.
Oral appliances are another non-surgical option an ENT may suggest, often with a dentist. These custom-made dental devices, such as mandibular advancement devices, are worn during sleep. They reposition the lower jaw and tongue slightly forward, which helps to enlarge the airway space and prevent soft tissues from collapsing.
For snoring primarily caused by nasal congestion, an ENT might recommend various topical solutions or devices. Nasal dilators, which are strips or cones inserted into the nostrils, can physically widen the nasal passages. Additionally, corticosteroid nasal sprays can reduce inflammation and swelling within the nasal lining, alleviating congestion.
Lifestyle modifications also play a role in non-surgical management, and an ENT provides guidance on these changes. Recommendations often include weight management, as excess weight can contribute to fat deposits around the neck that narrow the airway. Patients are also advised to avoid alcohol and sedatives before bedtime, as these substances relax throat muscles and can worsen snoring. Positional therapy, such as sleeping on one’s side instead of the back, can also be suggested.
Surgical Options for Snoring
When non-surgical interventions prove insufficient or are not suitable, an ENT may consider various surgical options to address snoring. Procedures targeting the palate aim to stiffen or remove excess tissue that contributes to airway vibration and obstruction. Uvulopalatopharyngoplasty (UPPP) involves removing parts of the soft palate, uvula, and sometimes tonsils to widen the airway. Palatal implants, small polyester rods inserted into the soft palate, help to stiffen it and reduce vibration. Radiofrequency ablation of the palate uses heat energy to shrink and stiffen the soft palate tissue.
Nasal procedures are performed to improve airflow through the nose. Septoplasty corrects a deviated septum, straightening the wall between the nostrils. Turbinate reduction procedures decrease the size of enlarged turbinates. By optimizing nasal breathing, these surgeries alleviate a common source of snoring.
Surgical interventions can also target the tongue to prevent it from obstructing the airway during sleep. Genioglossus advancement involves surgically moving the attachment point of a tongue muscle forward. Radiofrequency ablation of the tongue base uses controlled heat to reduce the volume of the tongue. These procedures help stabilize the tongue and maintain an open airway.
If enlarged tonsils or adenoids contribute to snoring, an ENT may recommend tonsillectomy or adenoidectomy. Removing these tissues can significantly open the upper airway. Surgical options are considered after careful evaluation, especially when other treatments have not provided sufficient relief or when specific anatomical issues are identified.