Long-term effects of radiofrequency ablation of the soft palate on snoring.

The objective of the study was to evaluate short- and long-term effects of radiofrequency treatment of the soft palate on snoring. Twenty-nine patients with habitual snoring were studied prospectively and treated up to four times at 4-6 week intervals with an Ellman Surgitrone®. Electromyography (EMG) of m. palatoglossus was performed in ten patients. Patients and partners evaluated snoring, sleep quality and daytime sleepiness 1 week preoperatively, 6 months and 3-4 years postoperatively. Snoring was reduced postoperatively (P < 0.0001). Sleep time increased, daytime sleepiness was reduced, and the partners slept better after 6 months. However, 3-4 years postoperatively only 25% of patients were satisfied. Another 25% had received additional treatment. EMG was normal in 6/10 patients preoperatively. They all continued to snore postoperatively. Four patients had pathological EMGs; three were responders. In conclusion, radiofrequency treatment for snoring may lead to long-term improvement in one out of four cases. Pre-evaluation with EMG may predict the outcome.

Positioner--a method for preventing sleep apnea.

CONCLUSIONS: A 'Positioner' preventing sleeping on the back can effectively reduce obstructive sleep apnea (OSA), but not always snoring for patients with long-term OSA. By preference, the device should be used for younger snorers without OSA as a training tool to avoid sleeping on the back. Instructions and support by a nurse are necessary for compliance. OBJECTIVES: Snoring is a progressive condition with a prevalence of 25-30% among the adult male population. Long-term snoring seems to be the basis for apneas caused by vibration damage to the pharyngeal tissue. Patients with OSA often have more apneas in the supine position than in the lateral position. Preventing sleeping on the back is a way to treat OSA. The aim of this study was to evaluate the efficacy and comfort of a recently developed Positioner. SUBJECTS AND METHODS: A total of 23 patients diagnosed with positional sleep apnea (AHI>15 in supine position and AHI<5 in lateral position), were included. The Positioner--a soft vest, attached to a board placed under the pillow, makes it impossible for the patient to sleep on his back. It was fitted and tried out individually. Patients answered sleep questionnaires and kept sleep diaries before beginning use. After 3 months, a new sleep study was done while using the Positioner and new questionnaires were filled out. RESULTS: Eighteen patients (5 women and 13 men) completed the study. The rest could not tolerate being strapped into the Positioner. Of those participating, 61% demonstrated a decrease of AHI to<10 using the Positioner. The Epworth Sleepiness Scale (ESS) decreased from a mean of 12.3 to 10.2. Half of the patients snored more frequently with the Positioner. The evaluation of comfort showed that minor adjustments are desirable.