Solutions to stop snoring
A Simple Painless Way To Stop Snoring?By Dr. Gifford Jones
“Giff, would you look at my throat?”, a medical colleague recently requested. He had been in great pain for several days after being treated for snoring by a new method called laser assisted uvula palatoplasty (LAUP). He was not amused by his doctor’s remark that “it’s a simple, painless, office procedure”. And he uttered a few choice remarks about the doctor that cannot be repeated in this column.
It was the first time I’d looked at a patient’s uvula and soft palate following this treatment. I was aghast at what I saw. It looked like a bomb had exploded in his throat. A “Silent night”, it seems, comes with a price!
Another patient, a Toronto executive, had a similar experience, with severe pain lasting for over two weeks. Asked if he would do it again, he smiled and said, “If I were single, no way, but it will help to preserve my marriage.”
He added, only half in jest, “Doctors should also promote it as a way to stop smoking and lose weight. My throat was so sore I could neither smoke nor take solids for 11 days.”
The LAUP was developed in 1988 by a French physician, Dr YvesªVictor Kamami of the Marie-Louise Clinic in Paris. In France over 2,000 LAUP’s have been performed.
It was introduced to North America by Dr. Josef Krespi, Director of the department of otolaryngology at St. Lukes-Roosevelt Hospital Center in New York and by Dr. Jack Coleman of Nashville’s Vanderbilt University in 1992.
Snoring occurs when an obstruction blocks the free flow of air through the passages at the back of the mouth and nose. This is normally caused by an enlarged uvula and excessive tissue of the soft palate.
Currently there are at least 300 gadgets on the market to treat snoring, devices such as neck collars, nasal clips, dental appliances and even electrodes.
Such gadgets work on the principal of waking up the person when he or she begins to snore. Or to make the individual uncomfortable when sleeping in positions that trigger snoring. Most snorers have found them unacceptable.
The rational for LAUP seems reasonable. In the procedure a carbon dioxide laser is used to sear off excess tissue of the uvula and soft palate which flaps back and forth and honks like a fog horn during sleep.
Why were my friends in such pain? Usually three to five treatments lasting about 10 minutes and spaced a few weeks apart are needed to remove the excess tissue. It appeared that doctors had removed too much tissue on one visit. And the laser beam had inadvertently struck more than the uvula and soft palate. Surgeon’s scalpels occasionally cut too deep into tissue and so can laser beams.
Apart from pain there appear to be few other complications. In 600 patients in Chicago and Nashville, physicians reported only two cases of post-operative bleeding. This occurred in patients who had been taking aspirin to prevent blood clotting.
But LAUP isn’t for every snorer. Doctors say that those suffering from sleep apnea or snoring that originates in the nose cannot be helped.
French studies indicate that about 85 per cent of patients with troublesome snoring can be cured by LAUP with virtually zero side-effects. And that the remaining 15 per cent experience a decrease in noise of snoring.
They may be right. But it’s illogical to believe a portion of the uvula and soft palate can be seared off without some degree of post-operative pain.
My concern is that some doctors will also become “laser happy”. A laser machine costs thousands of dollars so doctors may be anxious to recoup their costs. Give a carpenter a hammer and he will use it. Doctors are no exception to this rule. Besides what entrepreneur wouldn’t want to see patients lined up for this procedure when the fee for a few minutes work is $2,400 in the U.S. and $1,200 in Canada?
A word of caution to those who contemplate undergoing LAUP. The public tends to look on lasers as a 20th century “Buck Rogers” treatment. But don’t let the word “laser”, because it is new and innovative technology blind your judgment.
A distinguished surgeon at the Harvard Medical School once made a remark that all readers should remember when contemplating so-called minor surgery, “There is no such thing as minor surgery, but there are a lot of minor surgeons”. The results of laser treatment are only as good as the doctor providing it.
Dr. Gifford Jones Bio
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W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of The Harvard Medical School. He’s been a ship’s surgeon, hotel physician and family doctor and later trained in surgery at McGill in Montreal, University of Rochester N.Y. and Harvard. His medical column is published by 60 Canadian newspapers and several in the U.S. He is the author of seven books. Dr. Walker has a medical practice in Toronto. His Web site is: http://www.mydoctor.ca/gifford-jones He ca.n be reached at: