[Many persons with snoring problems and apnea are untreated. A review of therapeutic methods].
As sleep apnoea and snoring are very disabling conditions both for patients and their families, and hazardous for drivers and others in traffic, there is good reason to treat snoring problems. Treatment should be individualised, always beginning conservatively--i.e., positional training, weight reduction if necessary, more sleep if sleep deficiency is present, and a review of any muscle-relaxant or mucolytic medication. Sleep registration will demonstrate the extent of any sleep apnoea syndrome, which is of decisive importance for further choice of treatment. Mild apnoics and social snorers may initially be offered an occlusal splint if their dental status allows. Otherwise, in such cases surgery is a form of treatment yielding immediate results, though the patient must be forewarned of the discomfort which can occur in isolated cases. For patients with sleep apnoea syndrome of marked or intermediate severity, continuous positive airway pressure (CPAP) treatment should be available. If the patient can not tolerate CPAP treatment, the occlusal splint alternative can be tried. For patients who can not have CPAP or occlusal splint treatment, tracheostomy is a possibility. This treatment may be lifelong, but if weight reduction is achieved postoperatively, it may be possible to remove the tracheostomy.
Hultcrantz
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Halskliniken, Akademiska sjukhuset, Uppsala. elisabeth.hultcrantz@orl.uu.se
D006801:Humans; D009300:Nasal Septum / Q000601:surgery; D010845:Obesity Hypoventilation Syndrome / Q000601:surgery / Q000628:therapy; D017090:Occlusal Splints; D019647:Oral Surgical Procedures / Q000379:methods; D056948:Orthognathic Surgical Procedures; D010159:Palate / Q000601:surgery; D010614:Pharynx / Q000601:surgery; D011175:Positive-Pressure Respiration / Q000295:instrumentation; D011187:Posture; D020181:Sleep Apnea, Obstructive / Q000601:surgery / Q000628:therapy*; D012913:Snoring / Q000601:surgery / Q000628:therapy*; D014139:Tracheostomy / Q000295:instrumentation; D015431:Weight Loss