Snoring is a consequence of the complete or partial intermittent obstruction of the Upper Airway (UA) which interrupts ventilation during sleep and whose nocturnal repetition interferes with the smooth course of sleep.
Types of snoring
The symptoms of snoring can be simple without breathing abnormalities or complicated by being combined with various stages of respiratory disorders from obstructive hypoventilation, Upper Airway Resistance Syndrome (UARS) to Obstructive Sleep Apnoea Syndrome (OSAS).
Simple snoring : This is the breathing sound made by a person while they are asleep. Snoring is considered to be pathological when its intensity exceeds the 50 decibel threshold. Some snoring sound levels can exceed 100 decibels. Apart from the noise nuisance for other people, this snoring has no consequences for the snorer's health.
Snoring with respiratory events : This is snoring with respiratory events which are responsible for pathological micro-awakenings, lasting more than 3 seconds during the sleep. The snorer has signs of respiratory and cardiac struggle associated with snoring and excessive daytime sleepiness. There is destructuration of sleep and cardiovascular complications like high blood pressure.
Obstructive Sleep Apnea Syndrome (OSAS) : It should be considered whether, in addition to the snoring, the patient has symptoms such as sleep disorders, persistent fatigue, daytime sleepiness, stubborn headaches or badly controlled hypertension. The OSAS affects the general condition, resulting in neurological and cardiovascular risk, which has an impact on the snorer's social and professional life and can be dangerous when driving.
The snorer assessment
The assessment for any snorer consists of 2 consultations.
First consultation + additional assessment
It includes a regular ENT examination and an additional assessment. The doctor will assess the state of the oral cavity, the enlarged tonsils, the soft palate and uvula, as well as the articulation of the teeth and mandible.
To specify the site of the obstruction (nasal cavities, nasopharynx, tongue base and larynx) and the sound vibration (soft palate), the local examination is supplemented by a fibroscopy of the airways, which is conducted simply in a consultation by a local anaesthetic of the nasal cavities.
A more general assessment specifies the risk factors of snoring such as obesity, cardiovascular or neurological disease, lifestyle and dietary habits and the incidence of certain drug treatments for anxiety.
At the time of this first consultation an additional assessment is required :
- A sleep recording using a nocturnal ventilatory polygraphy will be scheduled by placing a "Holter" installed on the patient at the consultation to record a night's sleep. This examination takes place at the patient's home with the need to reduce the recording for interpretation; it will confirm the snoring, detect the importance of sleep apnoea (OSAS); it will also clarify the impact of micro nocturnal awakenings, oxygen desaturation episodes and restless leg movements.
- A radiological examination of the facial bones and sinuses.
It is used to summarise the additional assessment and propose treatment solutions
Techniques for treating snoring
There are several possible techniques according to the importance of the ventilatory obstruction of the snoring.
- Radiofrequency treatment done in the consultation according to the local obstruction site conditions, in the nasal cavities, the conchae, the soft palate the uvula and tonsils.
- Treatment with a mandibular advancement splint with the impressions made on the day of consultation to control the orthosis.
- A scheduled surgical treatment to treat the nasal obstruction, obstructive tonsillar hypertrophy and correct the soft palate's vibration factor (uvula).
- A positive pressure treatment will be considered in certain cases in which snoring is associated with predominant OSAS; the terms of this specific care will be considered in coordination with the GP according to the importance of the OSAS whose assessment can then be supplemented by polysomnography.
- Consultation: €150
- Holter sleep recorder: €350
- Radiofrequency: €400
- Procedure: €2,400