Nose

Snoring/ Sleep Apnea

Snoring is a noise produced during sleep that originates in the back of the throat or nose. Snoring occurs when the muscles in the back of the mouth, tongue and throat relax while sleeping, which narrows or blocks the airway. Breathing causes your uvula (soft palate) to vibrate and knock against the back of the throat, resulting in the snoring sound. Swollen or infected tonsils and adenoids, blocked nasal passages or a deviated septum can also narrow the airway and lead to snoring. Obesity, some medications and alcohol consumption before bedtime may contribute to snoring.

Snoring can also be a sign of a more serious problem, known as obstructive sleep apnea. With sleep apnea, the relaxed muscles at the back of the throat cause the throat to close, this stops breathing, typically from 20 seconds to up to three minutes. Most sleep apnea sufferers experience this cycle of snoring, apnea and awakening five or more times a night. Sleep apnea has a higher incidence among people age 40 and older, people with a family history of snoring and in postmenopausal women.

Because it disrupts the normal sleep pattern, sleep apnea makes you feel tired, slows your reaction time and can lead to confused thinking and memory loss. Other complications of sleep apnea can be high blood pressure, heart attacks, stroke, hypertension, anxiety and depression.

Sleep apnea is diagnosed through a physical examination with particular emphasis on weight, blood pressure and airway constriction in the nose, throat and lungs. In many cases, a sleep test will be recommended at a sleep laboratory. The sleep test monitors 16 different body functions while you sleep and can help identify the exact cause and severity of the sleep apnea.

Simple techniques for alleviating mild apnea are to sleep on your sides (not on your back) and avoid alcohol or sedatives before bedtime. In mild cases, treatment may consist of nasal decongestants, inhaled steroid preparations or oral mouth devices that force the jaw forward to prevent the tongue from falling back and constricting the throat. For more difficult cases, your doctor may prescribe a Continuous Positive Airway Pressure (CPAP). This device straps onto your face and generates pressurized air, which helps keep your airway open during sleep. In severe cases, surgery may be called for to open the airway, including a tonsillectomy, adenoidectomy or deviated septum repair.

If you suffer from debilitating snoring or think you may have sleep apnea, please contact our office and schedule an appointment with one of our otolaryngologists.

Nasal Fx

Nosebleeds (epistaxis)

The nose is an area of the body that contains tiny blood vessels that can break easily. Nosebleeds can occur at any age but are most common in children aged 2-10 years and adults aged 50-80 years. Nosebleeds are divided into two types, depending on whether the bleeding is coming from the front or the back of the nose.

Anterior Nosebleed- Most nosebleeds (or epistaxis) begin in the lower part of the septum, the semi-rigid wall that separates the two nostrils of the nose. The septum contains blood vessels that can be broken by a blow to the nose or edge of a sharp fingernail. Nosebleeds coming from the front of the nose (anterior nosebleeds) often begin with a flow of blood out of one nostril when the patient is sitting or standing. Common in dry climates or during the winter months when dry, heating indoor air dehydrates the nasal membranes.

Posterior Nosebleed- More rarely, a nosebleed can begin high and deep within the nose and flow down the back of the mouth and throat, even if the patient is sitting or standing. Obviously, when lying down, even anterior (front of nasal cavity) nosebleeds may seem to flow toward the back of the throat, especially if coughing or blowing the nose. It is important to try to make the distinction between the anterior and posterior nosebleed, since posterior nosebleeds are often more sever and almost always require a physician’s care. Posterior nosebleeds are more likely to occur in older people, persons with high blood pressure and in cases of injury to the nose or face.