About snoring

 

Snoring Therapies

The main activity of Medios Medical Center is to provide patients suffering from snoring and sleep apnea with diagnostic and therapeutic medical care.
All kinds of facilities are available for therapy in the form of either a treatment or consultancy.
 

Our mission is rather simple:
to improve the quality of your life and of those around you by suffering from snoring.

 

About snoring
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About the snoring
Nearly half of the adult population snore occasionally, and one in four snore regularly. It can cause resentment for the lives and social relationships of many people who otherwise do not suffer from the problem directly.

Primary or benign snoring

Primary snoring is a kind of sound occurrence during sleep owing to some constitutional and anatomical relation of the upper respiratory system, which is usually smooth-sounding, and sometimes is dependent on body position. A „benign” snoring does not cause damage to health, in the long term, however, may become antisocial or extremely disruptive to the sleeping partner. Constitutional changes developing in the respiratory system causes narrowing in the upper airway. During sleep, the movement of the air through this narrow passage speeds up, which vibrates the loose, soft tissues in the mouth and throat, thus creating the sound of snoring.



Pathological snoring, also known as pathological sleep apnoea

During pathological or abnormal snoring, an obstruction at some level of the upper respiratory system occurs due to the dysfunction of neural control of breathing, because of which it comes to a halt for a shorter or longer period. This is called sleep apnoea. The oxigen level in the body reduces due to lack of breath, which evokes an alarm reaction of a loud snort, after which the patient continues to sleep, though the process is repeated regularly during sleep. As a result, the natural process of sleep becomes interrupted, the patient is unable to get enough sleep, consequently, the work after might be disrupted by tormenting somnolence, fatigue or multiple, few-second sleep seizures, which could as well endanger the life of the patient while driving a car. Pathological snoring is characterised by the body’s decreasing oxygenation ability owing to troubled, poor sleeping processes, and therefore significantly increasing the risk of circulatory disorders such as heart attack, ischaemic attack, and many other diseases.

The Differential Diagnosis of Snoring, The Examination Process

A detailed sleep study is inevitable for the investigation of snoring or trouble breathing complaint. Medios Medical Center provides an opportunity to have a comfortable and extremely thorough examination at the patient’s home with the help of a sophisticated, sleep monitoring device, which enables easy patient access. The examination of physiological parameters during sleep gives the answeer for which type of snoring the patient is suffering from.
In the course of investigation it is equally important to have a comprehensive ear, nose and throat examination as well as to explore the possible abnormalities or tracheal stenosis of the upper respiratory system. Our doctors are helped with modern endoscopic and measuring instruments in order to make an exact diagnosis. In some cases, investigations are complemented with imaging studies, oral surgery consultation or neuro-psychiatric examination.

Effective therapy can be prescribed only after thorough investigation. The decesion whether the patient needs medication or instrumental support, perhaps surgery is to be made according to the findings.

General

Every patient is different and so is the problem. Since there is not a uniformly valid therapeutic option, the most important is to make a thorough investigation of the patient.
The investigation is basically twofold: to define and distinguish between the constitutional and anatomical differences of the upper respiratory system by carrying out a full-scale  ear-nose-throat, physical, and endoscopic examinations. Also, physiological parameters, respiration, possible breathing interruptions during sleep are all necessary to be explored with the help of a sleep study or polysomnography (PSG) conducted at the patient's home.

This is the first step in order to eliminate the annoying sound, and to find a unique, targeted solution for the patient's problem.

In the case of snoring and breathing disorders observed during sleep, the following anatomical abnormalities of the upper respiratory system occur:

In addition, patients often detect the problems themselves and complain about that it intensifies with ageing or the appearance of becoming overweight.

Personalized:
snoring and short of breath during sleep is of a complex origin, there is not a uniformly valid therapeutic option. We offer you a personalized therapy at Medios Medical Center.

Comprehensive:
Not only does Medios Medical Center focuse on one causal factor, but when needed, we also provide fully comprehensive, multi-level therapeutic solutions.

Comfortable:
At Medios Medical Center, our basic objective is to offer our patients comfortable, less stressful, minimal-invasive but sufficiently effective treatment.

At Medios Medical Center, the recommended theraputic options are all tried and tested and evidence based for treating snoring and sleep breathing disorders.

Our therapeutic possibilities:

Radiosurgery of soft palate and the pharynx

 

Due to muscle relaxation during sleep, an abnormal narrowing in the respiratory system, stenosis may occur. During sleep, the movement of the air through this stricture speeds up, which vibrates the loose, soft tissues in the mouth and throat, thus creating the sound of snoring. Soft palate surgery is performed to enlarge the narrowed passage of the upper respiratory system, the pharynx so that it remains wide during sleep despite the relaxed muscles or the tongue sliding back. It is also essential to tense the substance of the soft palate, which tends to loose, thereby reducing the induced vibrations and sound effect.

The surgery made with high-frequency radiosurgery device is not associated with extensive mucosal wounds and injuries and promises reduced bleeding and less pain.



It is the unique feature of radiofrequency technology to tense the vibrating substance of the soft palate, the so-called radiofrequency tissue volume reduction of the soft palate, whereby we can make thermocoagulation treatment with the appropriate handpiece of the radiosurgery device on the area under the soft palate mucosa.

The coagulation (burning) technique will cause scarring while the uvula and the soft palate will contract and become more toned, the pharynx will stay wide and resonate less on the turbulent flow of air.

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Nasal turbinate reduction with radiosurgery

Nasal concha (or turbinate) is a long, narrow and curled bone shelf (mucosal folds) that protrudes into the breathing passage of the nose. The largest one, the so-called lower nasal turbinate is by virtue of its tissue type construction very prone to swelling. Stenosis caused by nasal turbinate swelling creates turbulent air and can bring forth symptoms of nasal obstruction. The turbulent air flow increases the snoring sound effects, therefore more intense breathing is required in order to pass the air through the upper airway, otherwise the patient will sleep with their mouth open owing to poor nasal breathing, which further enhances the vibration of the loose upper respiratory system, thereby increasing the induced snoring sound. Long term swelling of the nasal turbinate is a very common problem among patients in need of continuous positive airway pressure (CPAP) therapy and whose nasal breathing disorders make it difficult for them to tolerate the device.


With lower nasal turbinate surgery, it is a fundamental requirement to take great care of the mucous membraine, as its being intact is crucial regarding  comfort. RF surgical technology fully complies with this requirement. During radiofrequency thermocoagulation of the lower nasal turbinate, the well-established electrode of the radiosurgery device is placed under the nasal mucosa, so that the nasal turbinate is treated according to selected strength of radio waves by inserting electrodes on two or three parts of it. Because of the intervention, scarring process under the nasal turbinate mucosa begins, which tightens up the turbinate by reducing its volume and as a result, improves nasal breathing. The intervention in reducing nasal congestion is also highly effective for patients who are allergic or permanently use nasal drops.




Pillar procedure (soft palate implants for reducing snoring)

Pillar procedure is a simple, safe and highly effective, minimally invasive method of treatment for benign snoring and mild to moderate case of sleep apnea. The innovation of the world-renowned Medtronic company is called Pillar implant procedure, which stops soft tissue vibrations by stiffening the soft palate and prevents pharynx from collapsing. In the course of the intervention, 3 pieces of thin, tissue-friendly, specially designed implants are put into the soft palate, which, after being grown over by tissues, imperceptibly increases the tone of the patient’s soft palate. A detailed physical examination for suitability should precede implantation.






Velumount®- For the Prevention of Snoring and Obstructive Sleep Apnea (OSA)


Velumount® is a medical device with CE registration which complies with current European health and safety standards and essential requirements.

Arthur Wyss, the inventor, developed and tested the Velumount ® over many years at the University of Bern in Switzerland. To date, more than 50.000 people are using the individually fitted device that successfully prevents snoring which develops in the area of the soft palate. Velumount® comfortably and gently opens the airways, preventing obstructions in the middle and upper throat area, thus reducing or even eliminating breathing interruptions and sleep apnea.


How does Velumount® work?

Function:When the Velumount® is inserted, closing of the airways is mechanically prevented and a constant airflow is thus secured. Snoring noises are directly eliminated.

The highly flexible plastic wire construction follows the muscle movements of the soft palate and tongue area with ease.
After the correct fitting of the device you will not feel any restrictions when swallowing or drinking.
When snoring is successfully prevented, it is also widely accepted that no sleep apnoea will be present. Snorers, however, who suspect sleep apnoea should undergo a professional sleep study following the adjustment period of the Velumount. This is to confirm the quality of sleep.

Material

The Velumount® is worn during the night when you are asleep.
The different material consistencies used must be adaptable to surface tension, strength, flexibility and individual wearing comfort.
The Velumount is available in different shapes and forms. The individual anatomy and wearing comfort were important factors when selecting the materials.
During the workshop you will have the opportunity to try different strengths of Velumounts and you will be well advised by our staff to find the most suitable device to suit your needs.

Who can benefit from using Velumount®?

• Snorers/sleep apnea sufferers who are looking for a simple and effective solution to their problem.
• Snorers/sleep apnea sufferers who have not had success with other forms of treatment.



Important:

The device can be fitted in one of our workshops which takes approximately 2-3 hours and includes full training in the handling of the Velumount.

We provide you two devices, and the aftercare is included in the price.

2 hours before the insertion we suggest not to eat!
 

Intraoral appliances, protrusion splints

Intraoral devices can prevent the jaw and the tongue from sliding back during sleep, so that those areas are safe from narrowing.

The device needs to be fitted onto the unique shape of the dental arches, and adjusted accordingly.

Somnoguard is high quality equipment, which is extremely well-tolerated and only requires a couple of minutes to fit even in a medical environment.

The device, which is made based on unique sample of the teeth and the jaws, look similar to a mouthguard, but they should be worn only during sleep.


Lifestyle Recommendations

 

 

 

 





Substantiated fact that a slight weight loss is effective inimproving sleep apnea and may reduce the intensity of snoring. If necessary, we provide all our patients with consultation ensuring them to lose weight effectively.

Some good advice for a healthy, good-quality sleep at night (stanford.edu):

1. Sleep only when you are tired: reduce time in bed staying awake.

2. If you can not fall asleep within 20 minutes, sit up, preferably in the dark, and think of something boring, monotonous, or start counting down from hundred until you feel sleepy. Light activates the brain, so you can become more alert again.

3. Do not sleep during the day as you get tired by the time you go to bed in the evening. If you still want to sleep, for it is part of your routine, make sure it is not longer than one hour in the afternoon, and is preferably over before 3 p.m.

4. Try to create a habit of going to bed and waking up at the same time each day so that you can help develop healthy sleep cycles.

5. Do not perform active exercise four hours before bedtime. Sport is highly recommended for a good-quality sleep in the morning or in the afternoon rather than in the evening when it may cause excessive liveliness.

6. Develop sleep rituals so your body will already know it's time to sleep: listen to soothing music, read good books, drink a cup of decaffeinated tea or do breathing relaxation exercise.

7. Lie down in a room kept well aired.

8. Do not have caffeine, nicotine or alcohol four hours before bedtime.

9. Have something light before bed, but also make sure you are not hungry when going to sleep.

10. Take a hot bath 90 minutes before bedtime.

 

Other instrumental therapy








 

 

Medios Medical Center provides their snoring patients with access to equipment that can help increase their own comfort as well as their sleeping partners:




Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea

Continuous positive airway pressure therapy (CPAP) uses a machine to help a person who has obstructive sleep apnea (OSA) breathe more easily during sleep. A CPAP machine increases air pressure in your throat so that your airway does not collapse when you breathe in. When you use CPAP, your bed partner may sleep better, too.

You use CPAP at home every night while you sleep. The CPAP machine will have one of the following:

- A mask that covers your nose and mouth.

- A mask that covers your nose only-called nasal continuous positive airway pressure, or NCPAP (this type of mask is most common).

- Prongs that fit into your nose.

You may want to try similar machines that have automatically adjustable air pressure or air pressures that are different when you breathe in than when you breathe out.

CPAP has many benefits. It can:

Many people who use CPAP report feeling better once they begin treatment. They feel more attentive and better able to work during the day. They also report fewer complaints from bed partners about snoring and sleep disruption.