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Dr. Júlio Stédile, M.D.

Facial Plastic Surgery

Facial Plastic Surgery
&
Otorhinolaringology

Snoring and Sleep Apnea

ronco_01Quality sleep is an integral part of a person’s quality of life, allowing the body to rest and recover in preparation for the next day’s activities. Some people, however, may present sleeping disorders that compromise the restorative effect of sleep, giving rise to effects that are not beneficial to health and have negative repercussions on health and daily activities. Since we spend virtually one third of our lifetime sleeping, it is important to know how to identify and treat disorders that affect the quality of our sleep and, consequently, our quality of life. Snoring and obstructive sleep apnea are disorders that commonly result from the combination of the narrowing of the upper airway and relaxation of the pharyngeal, oropharyngeal and tongue muscles, thereby leading to a collapse of the area during sleep.

Snoring

ronco_02Snoring is an important sign and symptom affecting a large part of the population.Primary snoring (snoring that is not associated with apnea and which affects 40% of the adult population) may appear at any stage of life and is an important sign of a number of pathologies that may involve the respiratory apparatus and can be associated with several diseases (that is, multiple factors may contribute to or aggravate snoring). Patients who snore must be thoroughly examined in order to analyze the factors contributing to the habit of snoring and to investigate whether sleep apnea is present or not. According to the causes of snoring, the physician will indicate the most suitable procedures for solving the problem.

Among the main causes of snoring or factors associated with the aggravation of snoring we can mention:

  1. Nasal obstruction: arising from septal deviation, external alterations of the nose, hypertrophy of adenoids and turbinates, nasal polyps, insufficiency of the nasal valve, alterations of the nasal structure.
  2. Flaccidity of the soft palate, uvula and lateral pharynx.
  3. Hypertrophy of tonsils and tongue
  4. Ptosis of the tongue (tongue drooping towards the posterior region of the throat)
  5. Micrognathia (small jaws), retrognathia.
  6. Short and overly fat neck
  7. Hypothyroidism and goitre
  8. Obesity
  9. Medications: Tranquilizers, anti-allergic drugs, muscle relaxants.
  10. Alcoholic beverage
  11. Smoking
  12. Poor physical activity and dietary habits.

Sleep Apnea

ronco_03Sleep apnea consists of respiratory pauses during sleep lasting more than 10 seconds. It may vary according to its etiology and intensity. It is a serious problem and must be identified as early as possible to prevent it from adversely affecting health and daily activities. It is commonly associated with snoring. Statistics demonstrate that car accidents with individuals who suffer from apnea occur 4 times as often as with those who do not have this condition because the individual becomes extremely sleepy during the day. Just like with snoring, sleep apnea is often associated with obesity and weight gain. It may result from an obstruction of the upper airspace (as well as from septal deviations, nasal pyramid deviations, hypertrophy of turbinates and adenoids, nasal polyps, micrognathia or retrognathia, hypertrophy of tonsils, small chin, etc.) or have mixed and central cerebral origins (central and obstructive origins), or arise from the Pickwick syndrome and upper airway resistance syndrome.

Consequences of the Sleep Apnea Syndrome

Sleep apnea can have as a consequence excess sleepiness during the day, morning headaches or a heavy sensation in the head, changes in mood and concentration, depression, sexual impotence, arterial hypertension, as well as social effects, among others.

Diagnóstico e Tratamento do Ronco e da Apnéia do Sono

Diagnosis is usually obtained through examination, initially by specialists in otorhinolaryngology and neurology, including nasal and laryngeal videoendoscopy (performed by an otorhinolaryngologist), imaging exams – x-ray or tomography, laboratory tests and polysonography (which assesses different parameters during sleep). Treatment may also involve specialists from other fields such as cardiologists, pulmonologists, endocrinologists, oromaxillofacial specialists, orthodontists, due to the multiple effects and associations to which the syndrome is related. Specifically regarding the treatment of snoring and sleep apnea of obstructive origin, the otorhinolaryngologist has a key role in identifying the problem and indicating the best solution through specific treatments that may include surgery, according to the cause of the disorder.

Surgical treatment is intended for correcting the obstruction of the respiratory airway and can consist of one or more combined procedures:

  1. LATERAL PHARYNGOPLASTY
  2. UVULOPALATOPHARYNGOPLASTY AND TONSILLECTOMY
  3. RHINOPLASTY
  4. SEPTOPLASTY
  5. TURBINOPLASTY
  6. POLYPECTOMY AND SINUSECTOMY
  7. ADENOIDECTOMY
  8. TRACHEOSTOMY
  9. ORTHOGNATHIC SURGERIES (OROMAXILLOFACIAL)
  10. TONGUE SURGERIES

Treatment also includes:

  1. CHANGE IN LIFESTYLE (REGULAR PHYSICAL ACTIVITY AND SUITABLE DIET)
  2. BETTER LATE THAN NEVER: Healthy habits (leisure, diet, physical and mental exercises) are a guarantee for prolonged youthfulness and better quality of life in old age, even when adopted later.

Orthognathic Surgeries (Oromaxillofacial)

In specific cases and for patients who cannot be subjected to surgery, the use of devices can be indicated:

  • CPAP
  • Intraoral devices
    It is important that the person who snores be aware that snoring is usually caused by many factors and that surgical procedures and lifestyle changes must often be combined, so that remission can occur. Not only does snoring bring about consequences to the individual, but it also affects the person’s social and family relationships. Sleeping well at night is essential for health, and this reflects favorably on one’s looks. Quality sleep lifts your mood and refreshes your looks. Sleeping well is an investment in health and beauty.

POSTOPERATIVE INSTRUCTIONS:

SURGERY FOR SNORING – TONSILS AND ADENOIDS

1st to 6th day – Pasty, cold diet. Food must be ingested in small amounts and slowly.

In the first week, do not expose yourself when the sunlight is strong. Attend the scheduled medical checkup on the informed date.

The following often occurs:

  1. Sore throat and earache
  2. Bad breath
  3. White patches on the throat
  4. Fever up to 38°C
  5. Constipation (if it lasts more than 2 days, take a laxative)

Call in case of:

  1. Hemorrhage
  2. High fever (39°C or above)

Rest for 3 days and speak as little as possible.

The Surgery for Snoring is often combined with a Cosmetic and Functional Surgery of the Nose. Also read the advice on Nose Surgery.

Dr. Júlio Stédile has vast experience in cosmetic and otorhinolaryngological surgery and is a world authority in these specialties.

BE WISE WHEN YOU CHOOSE A SURGEON. Just like in all other professions (lawyers, teachers, politicians, masons, cabinetmakers, baby-sitters, plumbers, etc.), there’s also a significant difference in the quality of the medical work provided.

REMEMBER THAT DIFFERENT SURGEONS HAVE DIFFERENT MEDICAL BACKGROUNDS, FOLLOW DIFFERENT PROCEDURES, HAVE DIFFERENT ESTHETIC VIEWS AND OBTAIN SIGNIFICANTLY DIFFERENT SURGICAL RESULTS.

Address

Dr. Júlio Stédile M.D.
Av. Dr. Nilo Peçanha, 2825/1403 ZIP CODE 91330-001
Bairro Três Figueiras - Porto Alegre/Rio Grande do Sul - Brasil
Phone: +55 (51) 2111-1017 / +55 (51) 2111-1018

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