Snoring and Sleep Apnea
- Comprehensive Evaluation
Dr. Zemplenyi firmly believes that severe snoring, whether or not
associated with sleep apnea, is a significant medical problem. Sadly
however, medical insurance plans exclude surgery for severe snoring from
covered services, unless the snoring is associated with documented
obstructive sleep apnea.
Thus, Dr. Zemplenyi approaches the evaluation
of a patient with snoring with two important questions in mind: 1. Does
the patient suffer "only" from snoring or is he/she likely to also have
significant sleep apnea? 2. Are the likely anatomical sites of
obstruction at the level of the soft palate (retro-palatal), base of the tongue
(retro-lingual) or
combination of both?
Dr. Zemplenyi uses his extensive training and
expertise to assess the severity of sleep disordered breathing, and to
assess the airway for possible sites of obstruction. A comprehensive
history as well as an examination of height, weight, (body mass index), nose, dental
occlusion, jaw size, tongue size, throat configuration, larynx and neck
size are obtained. Nasal fiberoptic examination in a sitting and a reclining position
is performed.
Further assessment of the problem usually involves an
overnight sleep study (a polysomnogram) obtained in a certified sleep
center and interpreted by a sleep medicine colleague. A sleep study
measures several important physiologic parameters such as brain waves,
heart rate & oxygen saturation, and it results in quantification of the
number, duration and severity of obstructive episodes that occur during
sleep. A rate of six or more episodes of partial or complete
physiological obstruction (respiratory distress index 'RDI'
or apnea/hypopnea index 'AHI' greater than 6) is by definition considered
medically significant.
This type of work-up results in two separate groups with different
initial treatments:
- Snorers without
Associated Sleep Apnea
- Severe Snorers with Obstructive Sleep Apnea |
