Struggling with Snoring: Seeking ENT Solutions for Better Sleep

A long-standing issue... snoring?

Hello, Dr.
Yeh.
I have been experiencing snoring for a long time, which has negatively affected my sleep quality and overall mental state.
My nose is usually congested on one side, while the other side is blocked.
I previously visited a doctor at Zhu Medical Center, but the doctor was dismissive and only prescribed some medication, which did not help at all.
I have heard that the doctors at Chang Gung Memorial Hospital are very capable, but it is quite far for me to travel.
Could you please let me know if there are any doctors in Miaoli or nearby who could help me?

Steven, 30~39 year old female. Ask Date: 2005/01/24

Dr. Ye Dawei reply Otolaryngology

Mr.
Steven, please come to the outpatient clinic for an examination to clearly understand the cause and treatment options.
If the issue is due to nasal congestion, a nasal laser surgery may be performed.
If a uvulopalatopharyngoplasty is required, I recommend visiting Chang Gung Memorial Hospital.
My outpatient hours are Monday, Wednesday, Thursday, and Friday mornings.

Here is a reference article: "The Child's Snoring is Like Thunder" – Snoring and Sleep Apnea Syndrome.
"At night, drinking Dongpo wine, I wake up and feel tipsy again, returning home at the third watch.
The child's snoring is like thunder..." Su Dongpo vividly depicts the scene of a child's snoring in his poem "Linjiang Xian," making one feel as if they are experiencing it firsthand.
In the ENT clinic, many patients, regardless of age, often seek treatment due to loud snoring, with family members fearing that the patient might experience sudden death due to breathing cessation.

Here is a brief introduction to snoring and the more severe condition known as sleep apnea syndrome.
"Snoring" refers to the sound produced by the vibration of soft tissues in the soft palate when breathing through the mouth, influenced by airflow.
More severely, "sleep apnea syndrome" not only involves snoring but also includes other symptoms such as observable breathing cessation during sleep, sudden awakenings, difficulty breathing, frequent urination, choking, and coughing.
During the day, patients may feel poor energy, lack of concentration, memory decline, restlessness, and excessive daytime sleepiness due to poor sleep quality.
Under normal circumstances, neither adults nor children should snore if they are breathing through their noses; snoring occurs when mouth breathing causes airflow to vibrate the soft tissues of the soft palate.
Therefore, snoring is more common in patients with upper respiratory infections or allergic rhinitis.
Children may snore due to enlarged adenoids causing nasal obstruction, while adults, especially middle-aged men who are overweight, have short necks, large tongues, or short jaws, are more likely to snore due to the need to breathe through their mouths.
Sleep apnea syndrome refers to intermittent cessation of breathing during sleep due to airway obstruction, characterized by five or more breathing cessations per hour, with each cessation lasting more than ten seconds.
During these apneic episodes, the patient's chest may show respiratory movements, but there is little or no airflow through the mouth and nose.
The obstruction can occur in the nasal area, soft palate, or base of the tongue.
This obstruction leads to decreased blood oxygen levels and increased carbon dioxide levels, stimulating the respiratory center to initiate forceful breathing, which causes snoring.
This process repeats throughout the sleep period.
To accurately diagnose this condition, the most important factors are the descriptions provided by family members regarding the patient's sleep patterns, along with the patient's self-reported sleep quality and daytime alertness.
Additionally, the physician will examine potential obstruction sites in the nose, mouth, tongue, chin, or neck and assess for obesity.
Hospitals can utilize sleep questionnaires, physiological monitoring devices, overnight oxygen monitoring, skull X-rays, CT scans, and even MRIs to observe changes in snoring, eye movements, brain waves, blood pressure, heart rate, muscle activity, and blood oxygen levels during sleep.
A fiberoptic endoscope can simulate the narrowing of the oropharynx during sleep.
The easiest condition to treat is snoring caused by nasal congestion, which can be resolved with medication or surgery to clear the nasal passages.
In contrast, sleep apnea syndrome does not respond well to medication.
Physicians will first emphasize the importance of weight loss, maintaining a regular schedule, engaging in appropriate exercise, avoiding smoking and alcohol, and refraining from medications that may cause muscle relaxation, such as sleeping pills, sedatives, or antihistamines.
Snoring or mild sleep apnea syndrome can be treated with local anesthesia using laser, radiofrequency, or local injection sclerotherapy.
Moderate to severe sleep apnea syndrome requires more complex surgeries, typically performed under general anesthesia, such as uvulopalatopharyngoplasty (UPPP).
Additional procedures may include mandibular advancement, tongue base reduction, and hyoid suspension, all aimed at increasing airway space and strengthening surrounding tissues to prevent symptoms caused by tissue relaxation in related areas.

Reply Date: 2005/01/24

More Info

Struggling with snoring can be a frustrating experience, especially when it affects your sleep quality and overall well-being. Snoring is often a symptom of underlying issues, such as nasal obstruction, sleep apnea, or other respiratory problems. Given your description of having one side of your nose frequently congested, it’s essential to address these concerns comprehensively.

First, it’s important to understand that snoring occurs when the airflow through the mouth and nose is partially obstructed during sleep. This can be due to various factors, including nasal congestion, enlarged tonsils or adenoids, obesity, or anatomical variations in the throat. In your case, the persistent nasal congestion could be a significant contributor to your snoring. Chronic nasal obstruction can lead to mouth breathing during sleep, which is often louder and more disruptive than nasal breathing.

Here are some steps you can take to improve your situation:
1. Consult an ENT Specialist: Since you’ve already seen a doctor who didn’t provide satisfactory results, seeking a second opinion from an Ear, Nose, and Throat (ENT) specialist is crucial. They can perform a thorough examination of your nasal passages and throat to identify any anatomical issues, such as deviated septum or nasal polyps, that may be contributing to your snoring.

2. Nasal Decongestion: If your nasal congestion is due to allergies or sinus issues, consider using saline nasal sprays or over-the-counter decongestants. However, be cautious with prolonged use of decongestant nasal sprays, as they can lead to rebound congestion.

3. Sleep Position: Your sleeping position can significantly impact snoring. Sleeping on your back often worsens snoring, as it allows the tongue to fall back into the throat. Try sleeping on your side instead. You can use pillows to help maintain this position.

4. Weight Management: If you are overweight, losing weight can significantly reduce snoring. Excess weight, particularly around the neck, can put pressure on the airway, leading to obstruction during sleep.

5. Avoid Alcohol and Sedatives: Alcohol and sedatives relax the muscles in your throat, which can increase the likelihood of snoring. Try to avoid these substances, especially in the hours leading up to bedtime.

6. Establish a Sleep Routine: Maintaining a consistent sleep schedule can improve your overall sleep quality. Aim to go to bed and wake up at the same time every day, even on weekends.

7. Humidify Your Bedroom: Dry air can irritate the nasal passages and throat, leading to increased congestion. Using a humidifier in your bedroom can help keep the air moist and reduce snoring.

8. Consider Oral Appliances: If your snoring is related to sleep apnea, an oral appliance designed to keep your airway open may be beneficial. These devices are custom-fitted by dental professionals and can significantly reduce snoring.

9. Surgical Options: In cases where structural issues are identified, surgical intervention may be necessary. Procedures can include correcting a deviated septum, removing enlarged tonsils or adenoids, or other surgeries aimed at improving airflow.

Regarding your question about finding a suitable ENT specialist in Miaoli, I recommend checking with local hospitals or clinics that have an ENT department. You can also look for recommendations from friends or family who may have had similar issues. It’s essential to find a doctor who listens to your concerns and provides a thorough evaluation.

In summary, addressing your snoring requires a multifaceted approach, starting with a proper diagnosis from an ENT specialist. By tackling the underlying causes of your nasal congestion and snoring, you can improve your sleep quality and overall health. Don’t hesitate to seek help until you find a solution that works for you.

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