Snoring and Basic Definitions
What is snoring?
Snoring is the disturbing sound created by vibration in soft tissues as air passes through a narrowed upper airway.
Is snoring a health problem?
While snoring is a social problem that disturbs those around you, it can also be considered a health problem since it is the most common symptom of sleep apnea.
What is sleep apnea?
A breathing pause lasting more than ten seconds during sleep is called apnea.
What is hypopnea?
Hypopnea is a milder form of apnea, defined as a decrease in breathing volume or oxygen saturation during sleep.
What is restless leg syndrome?
It is described as increased leg movements during sleep. Increased leg movements cause the sleep to become fragmented and its structure to deteriorate.
Oxygen and Diagnosis
What should the oxygen level be during sleep?
In a normal person, the average oxygen level is above 90-95%. Values that drop below 90% must always be investigated.
What is sleep apnea disease?
Sleep apnea is diagnosed when more than 5 apneas and hypopneas per hour are detected during sleep.
What are the most noticeable symptoms of sleep apnea?
Snoring, breathing pauses noticed by a bed partner at night, increased daytime sleepiness, morning headaches, waking up feeling unrested, nighttime incontinence, night sweats, fatigue, sleepiness, and fluctuating hypertension.
Are the symptoms of sleep apnea the same in children as in adults?
In children, alongside nighttime breathing pauses and snoring, daytime restlessness, a decline in school performance and growth-development delays are seen.
Diagnostic Process
How is sleep apnea diagnosed?
It is suspected after an ENT examination; a definitive diagnosis is made with polysomnography, i.e. a sleep study.
Where is a sleep study performed?
It is possible to have a sleep study done in sleep laboratories or at your own home with advanced devices.
How is sleep apnea diagnosed in children?
While diagnosis can be made with a sleep study, performing a sleep study on children is more difficult; the doctor may request an overnight video recording.
I've had my sleep study done, what should I do now?
Following the recommendations of the physician who performed the test, you should first consult an ENT specialist.
What is done during a sleep apnea examination?
After a specialist examination of the nose, the inside of the mouth, the tonsils and the soft palate, narrow areas are identified with an endoscopic examination.
Is endoscopy always necessary?
Awake endoscopy is essential in a sleep apnea examination; however, sleep endoscopy may not be performed if suitable data has already been obtained.
Treatment Options
What are the treatment alternatives for sleep apnea?
Depending on the patient, methods such as PAP therapy, surgical treatment, an oral appliance, sleep hygiene, position therapy and weight loss may be offered.
What is CPAP therapy?
CPAP is one of the first treatment methods we turn to for sleep apnea. In this treatment, a device increases the pressure of air taken from outside and delivers it to the upper airway.
Can everyone use CPAP therapy?
About 50% of patients prescribed CPAP therapy cannot use this device, as it is used with a mask.
What are the surgical treatments for sleep apnea?
Surgical treatments targeting the palate, tongue base and nose can be performed in stages or at multiple levels.
Who performs sleep apnea surgery?
Sleep apnea surgery is performed by ENT specialists experienced in this field.
Is sleep apnea surgery difficult?
Pain may be experienced for up to one to ten days after surgery, but most patients can tolerate this; a hospital stay of 1-3 days may be required.
Is it possible to stop using a CPAP device through surgery?
With surgical techniques developed today, the success rate of sleep apnea treatment has increased considerably; with appropriate treatment, it is possible to stop using the device.
I am overweight, does this prevent me from having sleep apnea surgery?
Weight loss is the most important factor that increases treatment success; bariatric surgery may also be recommended if necessary.
Surgical Techniques
What palate and uvula surgeries are used for sleep apnea?
Expansion pharyngoplasty, anterior palatoplasty and transpalatal advancement techniques are used.
Is removing the uvula necessary in sleep apnea surgery?
It is absolutely not necessary. Because the uvula's contribution to swallowing is significant, we do not remove it with our current techniques.
What tongue surgeries are used in sleep apnea?
The plasma method or robotic surgery, which are used to reduce the tongue base, are among our preferred methods.
What is jaw surgery?
It is a surgical method aimed at surgically advancing the upper and lower jaw for patients with severe sleep apnea who cannot use CPAP; the success rate is about 90%.
Does my voice change after sleep apnea surgery?
Modern surgical techniques used today do not cause an objective change in voice resonance or tone.
Sleep Apnea in Children
What is the treatment for sleep apnea in children?
The technique we most commonly apply for sleep apnea in children is adenotonsillectomy, i.e. adenoid and tonsil surgery.
My child had adenoid and tonsil surgery but still snores, why could that be?
The most important cause of continued snoring is allergy; it improves with appropriate allergy treatment. The second cause may be epiglottis problems at the entrance of the larynx.