Non
Surgical treatments Mandibular
splints
A device worn in the mouth overnight resembling a sports
gum-shield can be fitted so that it pulls the lower jaw (mandible)
forward a few millimetres. This may be sufficient to bring the tongue
forward a little and increase the airway space at the
back of the throat thus reducing snoring noise. There are
several such devices available. They may cause aching
discomfort in the jaw joint in some patients but most are
able to tolerate the mandibular splints. The success rate
in reducing snoring noise in the long term can be
disappointing but they may be useful in the short to
medium term in patients who prefer to avoid more invasive
treatments. (see sources of more
information)
Nasal CPAP
Continuous Positive Airway Pressure (CPAP)
is a method of administering air to the back of the
throat via a plastic mask fitting tightly around the nose.
The mask is connected to a small electrically powered air
compressor via a flexible plastic hose. The air pressure is adjusted to
a high level so that the soft tissue at the back of the
throat is pushed apart and the patient is able to breathe
without obstruction. The beneficial effects can be
dramatic and immediate especially in cases of severe OSA.
Snoring noise is also eliminated although many patients
feel that the inconvenience of wearing the apparatus is
almost as bad as the original snoring noise.
Nasal Airways
Various non-surgical methods may usefully be tried in
order to improve the nasal airway. These include topical
nasal steroid sprays such as Beconase or Rhinolast (available
without prescription in UK) or nasal decongestant sprays
eg. Otrivine or Ephedrine. Note the decongestant sprays
must be used sparingly for periods of maximum one week in
order to reduce risk
of damage to the nasal lining. Plastic nasal splints are
also worth trying as an experiment to temporarily open
the nostrils a little wider during sleep. Success in
reducing snoring by sprays or splints would suggest
surgery may offer a more lasting solution.
Palate sprays
Sprays are available which are applied to the soft palate
before bedtime. They act as a mild irritant to the palate
and can help reduce snoring noise. Generally the effect
is not long-lasting.
Drugs eg Protryptiline
Snoring is usually most marked during REM
sleep. This is when the pharyngeal muscles are maximally
relaxed. Drugs such as protryptiline are used to reduce
the REM phase of sleep and consequently shorten the
period of snoring. Although they can be effective in some
patients, most people would prefer not to take medication
long term which alters the natural sleep pattern in this
way.
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