Three steps to combat hardened snorers

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The Independent Online
A NEW treatment for snoring which takes 20 minutes and is successful first time in 30 per cent of cases has been introduced into Britain.

It provides a realistic hope of peace at night for the worst affected partners. A quarter of the middle-aged population snore regularly with more in old age; some snorers achieve noise levels louder than a pneumatic drill.

The technique uses a laser to reshape the soft palate including the uvula, the fold of loose tissue which hangs down from the centre of it.

Its drawbacks are that it is not cheap, not yet available on the NHS and that at first the treatment gives the patient a very sore throat.

Until now, snorers and their beleaguered partners had to rely on a number of patented anti-snoring devices - head straps, chin straps and nostril dilators - or, for a small number of the most serious cases, an operation under general anaesthetic, which could lead to nasal regurgitation caused by food going up the back of the nose, and occasionally a speech defect. The only other alternatives for sleepless partners have been to endure it or to move to another room.

The new procedure, Laser Assisted Uvulo-palatoplasty, was developed by a Paris surgeon, Yves Kamani. According to David Garfield Davies, a London consultant otolaryngologist who has studied the method, it has taken off in in both France and the US.

Snoring is caused by the obstruction of the airways at the back of the nose and throat by the soft palate's flabby tissue. With age this is likely to get worse as muscle tone reduces. The noise is caused by the tissue vibrating.

Mr Garfield Davies, who works at the private London Clinic and the Royal National Throat Nose and Ear NHS Trust, explained the new treatment which is performed under a local anaesthetic: 'It is a staged, outpatient treatment to tighten the soft palate. We do not remove more tissue than is necessary and it avoids the complications of the old operation. People can come in after work in the evening for the treatment and go home afterwards.

'First we spray a local anaesthetic on to the back of the throat and inject the local anaesthetic at three points at the base of the uvula using a very fine needle. Then we make a tiny trough or nick with the laser, 3mm to 6mm long, upwards on either side of the uvula. Then we laser the lower part of the uvula to refashion it and to make it shorter.'

The effect is to reduce and tighten the soft tissue, causing tougher scar tissue to form in a small area. ''Patients have a bad sore throat for three to five days and need quite strong pain relief, and then a sore throat for about ten days,' he said.

The treatment may need to be repeated for intractable snorers, but for many, once can reduce the bedroom noise levels and the constancy of the snoring sufficiently to make sleep possible for partners or spouses.

The laser operation is understood to cost under pounds 1,000 for each treatment: the London Clinic was unable to give a price because of medical advertising restrictions.

One of the first men in this country to have the treatment is again able to sleep, nightly, in the same bed as his wife. He has snored for 30 of his 52 years, and the couple had often resorted to separate bedrooms. 'The noise I made was excruciatingly loud, so loud it used to wake me up as well. My wife used to throw me out of bed,' he said.

The patient, who asked not to be named, said he knew something had to be done when even his wife's ear plugs could not prevent her sleep being disrupted. Sometimes it was so bad that on holidays, his wife would sleep on their hotel room's balcony. After the operation, the patient suffered discomfort for three to four days and now he snores only slightly. His wife said: 'I think his snoring is both quieter and less frequent, but it is hard to say since I can now stay asleep. It's not perfect but we can sleep in the same room.'

Snoring is not just a nightmare for the families forced to listen, but can indicate the presence of another condition, obstructive sleep apnoea. In this, the snorer stops breathing briefly - up to 300 times a night - resulting in inadequate sleep and potentially dangerous daytime drowsiness.

Sleep researchers believe increasingly that the effects of this type of snoring are responsible for some road accidents where drivers fall asleep at the wheel.

Obesity encourages snoring, as does anything which promotes deepest sleep. So snorers should avoid nightime sedation, says Mr Davies, as well as alcohol, but these could be a good thing for their partners. 'The partner should always try to get to sleep first so she should have the drink and the snorer should have the black coffee, so he drops off a bit later.'

The record for the loudest snorer, according to the Guinness Book of Records, is a Southampton man at 91 to 92 decibels. A previous holder from Vancouver, Canada, hit 90. With the city's traffic noise- pollution limits set at 80, he wondered if he was legally permitted to sleep at home.

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