Host: Welcome back. Well if you sleep with someone who snores then you know it can be annoying as a problem, and in some cases it can also be a sign of something serious.
Host: So today various treatments of snoring is keeping you or your partner up at night. Dr. Hilel Swerdlin is with Sinus & Snoring MD and his team identifies the causes of sleep and snoring problems and helps patients find relief too. Great to see you.
Dr Swerdlin: Great to see you, thank you.
Host: Thanks for being here. Let’s talk about what causes snoring because I know a lot of people have heard of sleep apnea too, but they’re not always sure what causes snoring and sleep apnea.
Dr Swerdlin: Well snoring is caused by narrowing or partial blockage of the upper airway. The upper airway starts in the nose and it includes the right and left nostril. The airway goes back in the nose and dives down into the throat, goes behind the throat, behind soft palate, behind the tongue and then it gets into the airway. So if there’s any blockage in any of those areas you have turbulent airflow and that causes vibration. What I like to tell my patients, imagine that your upper airway is a garden hose and there’s water coming out and the moment that you squeeze it, the water starts comes out with a tremendous amount of pressure and that causes vibration.
Host: Right, so that’s causing the snoring. Does that change throughout life? Because I always wonder like if you have an anatomical problem like that, is it like that since you were a kid or can that change when you’re older?
Dr Swerdlin: It can change over life, for example if you gain weight the throat becomes much smaller. You get like a little belly inside of your throat.
Host: Yeah.
Dr Swerdlin: We also see patients that are very athletic that are very strong so they are growing muscles inside of the throat, where you don’t want muscles or a belly, you want an airway.
Host: Oh, I didn’t know that. Yeah.
Dr Swerdlin: Then you can develop sinus infections, polyps, nasal polyps, allergies that can also cause snoring.
Host: What can people do to take care of it at home?
Dr Swerdlin: That’s an excellent question. There’s a lot of remedies out there and some of them are actually effective.
You know, if they address the upper airway for example they have devices to open up the nose that you can use, they have sprays to try to open up the nose, some of those can actually be addictive so they can be problematic. And then one of the main issues of snoring is the tongue falls back into the throat so they have devices to prevent the tongue from falling back, mouth pieces kind of the ones like athletes use. And they have also chin straps and they have pillows to prevent you to sleep on your back, different beds. Not everything works but…
Host: It’s worth trying, yeah. Different options, at least.
Dr Swerdlin: Another important one is losing weight. Weight is probably one of the main causes of snoring and sleep apnea. That’s another one.
Host: Absolutely. If a patient wants to come in to be evaluated, what do they expect when they come to your office for that evaluation?
Dr Swerdlin: Yes, when they come in we like to make them feel at home, so we have a nice conversation, formal conversation, and then we do a very thorough evaluation of the upper airway--which is painless.
You know, people are worried that it’s going to be painful, but we use a tiny little spaghetti camera and we are able to look in the nose and all the airways. And we actually make a high definition video to share with our patients. If we need to, we can do imaging studies.
We can also do a home sleep test if we're concerned the patient might have obstructive sleep apnea, which is where you actually stop breathing in the middle of the night and we have three different types of sleep tests that we can use. One of them actually evaluates snoring very well and sleep apnea because it allows you to sleep in every single position. It’s a little watch, so some patients all they need is to not sleep on their back. You know, so we have all that evaluation.
Host: So once you evaluate it, diagnose it, then what treatments do you have available for snoring as well as sleep apnea?
Dr Swerdlin: So once again we address the upper airway, an easy thing to do is open up the nose. It's a simple office procedure to ensure they can breathe better. There’s a brand new FDA procedure that’s like the facelift of the throat. It’s called the Elevoplasty and we use implants to stiffen the throat and we have little sutures that bring up the throat. We also have procedures to give a little shave of the soft palate. If the tonsils are very large, we can actually shrink them, like give them a little liposuction to the tonsils. And we also have the ability to prescribe CPAP if it’s necessary or a mouth piece.
Host: Okay so if somebody’s got fat tonsils gotta liposuction them.
Dr Swerdlin: Liposuction of the tonsils, that’s right.
Host: That’s cool. So a lot of these, some of these procedures that you’re talking about are they in office procedures?
Dr Swerdlin: A lot of them can be done in the office.
Host: Wow.
Dr Swerdlin: Yeah, we have a significant amount of anesthesia options so we can do it in the office. Just, sometimes it’s just a spray, sometimes it’s a gel.
Host: You might be awake.
Dr Swerdlin: Yeah, sometimes it’s the laughing gas which makes you really relaxed, it is a favorite of patients. We can give you mild sedation or Twilight or if we need to, take you to an operating room where we have a nearby surgical center operating room where we can go. We can do the majority in the office.
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