Good Nights : Surgery Puts Snoring to Rest
Jan Smith woke up on the couch again, forced out of her bedroom by her husband for the fourth time that week. Jim wasn’t a tyrant, nor was their marriage on the rocks.
The Smiths are just two of the estimated 60 million Americans disturbed each night by snoring.
Jim, a 44-year-old real estate agent, has always snored and never thought much of it.
His attitude was: What could he do about it?
Jan took the noise pollution that disrupted intimacy harder: “I love sleeping with him. After all, he’s my husband.”
Heavy snoring like Jim’s is more than a marital stress, according to sleep researchers. It can indicate a potentially serious problem called sleep apnea. Because of an obstruction in the airway--tonsils, adenoids, an enlarged uvula or soft palate, or excessive tissue on the side of the throat--victims of the disorder can’t breathe properly during sleep.
Hundreds of times a night, during episodes called apneas, the sufferer actually stops breathing for intervals lasting 10 to 180 seconds.
Apnea occasionally causes fatal cardiac arrhythmia, or irregularity in the heartbeat. The noisy gasps for air that eventually open the airway prevent deep sleep and a well-rested feeling. Now, sleep disorder centers are making great strides in pinpointing apnea and other sleep problems and are treating them with therapies ranging from medication to surgery.
When Jim checked in at the California Center for Sleep Disorders in Oakland, Calif., he learned that 90% of sleep apnea sufferers are middle-aged, overweight men like himself. People tend to gain weight as they age, and the extra fatty tissue, especially in the neck and throat, may make it more difficult to breathe while sleeping.
While Jim spent the night in the center’s sleep laboratory, his brain waves, heart rate, breathing pattern, body movement, snoring and oxygen level were monitored.
In the morning, the records showed that Jim had stopped breathing an average of 20 times each hour, occasionally for as long as 45 seconds at a time.
He had a moderate case of sleep apnea.
Dr. James Piepergerdes, a local ear, nose and throat specialist, agreed to help Jim. First, he said that there are a variety of treatments for sleep apnea, many very simple. Weight loss can increase the diameter of the airway. Sometimes a small change in position can help: Sleeping on one’s side seems best.
More drastic treatments include continuous positive airway pressure, in which the sleeping patient breathes through a nasal mask that draws in air from a tank, thus expanding his airway. Surgery can correct or remove obstructions.
To isolate Jim’s problem, Piepergerdes X-rayed his throat and jawbone and used an eyepiece on a flexible tube to see the back of Jim’s throat.
After the exam, the doctor recommended palatopharyngolplasty: the removal of one-third of the soft palate and the uvula, a structure used only for certain sounds, such as the French “r.” The surgery, done under a general anesthetic, is 90% successful at stopping snoring or reducing it so it’s no longer a nuisance, and 60 to 70% effective in decreasing sleep apnea.
After surgery, Jim’s snoring and sleep apnea vanished. “I’m much more alert and productive during the day,” he says. “Surgery has also enhanced my sleep. Now I have a lot of vivid dreams.”
“I’m so happy with the way things worked out,” adds Jan. “Now we both sleep at night.”
