Sleep Disordered Breathing FAQ’s

1. What is snoring and what causes it?

A: Snoring is the fluttering sound created by the vibration of tissues in the back of the throat and nose. These vibrating tissues may include the soft palate, throat, uvula, tonsils, and adenoids.

The following factors contribute to both snoring and obstructive sleep apnea (OSA):

• Your anatomy – obstruction of the upper airway, with the soft palate being the most common factor
• Your lifestyle – weight gain, alcohol consumption, and smoking
• Your body’s aging – tissue elasticity decreases with age, allowing more chance for vibration
• Poor mental and emotional health

2. Are there any actual negative consequences to snoring?

A: There are several negative consequences to snoring, including –

• Daytime sleepiness
• Poor mental and emotional health
• Decreased productivity
• Slower reaction time
• Vehicle accidents
• Unhappy bed partner

3. What is sleep apnea or obstructive sleep apnea (OSA), and what causes it?

A: Apnea is a Greek word meaning “without breath.” OSA is caused by the collapse or obstruction of the upper airway, occurring at one or a combination of levels –

• Nasal airway
• Soft palate/tonsils
• Tongue base
• Pharyngeal walls

4. Are there any actual negative consequences to sleep apnea?

A: Consequences include –

• Hypertension
• Myocardial infarction (heart attack)
• Stroke
• Type II Diabetes
• Depression
• Cognitive dysfunction
• Impotence, sexual dysfunction, reduced libido
• Morning headaches

5. How common is sleep disordered breathing? (Including both snoring & sleep apnea)

A: More than 75 million Americans suffer from sleep-disordered breathing, including snoring and OSA. It affects 24% of adult males and 9% of adult females. More than 1.3 million Americans are diagnosed with obstructive sleep apnea (OSA) annually.

6. What part of the ear, nose, or throat anatomy contributes most to snoring?

A: The soft palate (mouth) is the primary contributor in 80% of snoring and a major anatomical contributor in OSA.

Severe OSA Treatments

1. Which surgical treatments for severe sleep apnea are covered by insurance?

A: UPPP (Uvulopalatopharyngoplasty) is a procedure performed under general anesthesia in a hospital setting to remove tissue at the back of the throat (tonsils, uvula, and part of the soft palate) and thus enlarge the oral airway. UPPP surgery is extremely invasive, involving significant pain, high risk of complications, and recovery time of two weeks or more with only ~40% success rate.

Tonsillectomy is another major dissection surgery, somewhat less invasive in that it involves only removal of the tonsils, which are typically overly large.

Although the majority cost of either of these surgeries is covered by insurance, the patient out-of-pocket cost is typically as high as the total cost of receiving the Pillar® Procedure treatment.

2. Are there any non-surgical treatments that are covered by most insurance plans?

A: Yes, the CPAP (continuous positive airway pressure) device is considered the “gold standard” of non-surgical care for OSA. These devices have been around for a long time and they do work, but CPAP treatment often fails for the following reasons –

• Lack of patient compliance/tolerance, with reported compliance often as low as 40-50%
• The machine noise is often as disturbing to patients and bed partners as snoring/gasps of breath
• Patient must transport machine with them when traveling

About Sleep Studies

1. What is a sleep study?

A: A sleep study is an overnight sleep test. You are monitored either in an overnight sleep lab, or by a take-home sleep monitor. This type of study is recommended to diagnose or rule out a sleep disorder such as obstructive sleep apnea (OSA), narcolepsy or other disorders.

2. When is it appropriate to do a sleep study?

A: Sleep studies are necessary in order to obtain objective information characterizing sleep issues a person may have. A disorder like OSA increases a person’s risk of hypertension, heart attack, stroke, and even death.

3. How do I participate in a sleep study?

A: Call us directly to discuss sleep study options. Alternatively, you can discuss this topic with Dr. Macdonald at your consultation/examination appointment. Basically, there are two options for how to engage in a sleep study: 1) home sleep study using a kit provided by a sleep lab, 2) sleep at the sleep lab under direct monitoring and supervision of their staff. Either way, the sleep lab will evaluate your results and share them with your doctor.

Scheduling a Consultation

1. How do I schedule a consultation/evaluation for snoring?

A: Call our office to schedule an appointment, and plan on visiting with Dr. Macdonald so that he can thoroughly evaluate your specific issues and review your potential treatment alternatives.

2. How much does it cost for a consultation appointment?

A: The fee for consultation is $100. In some cases Dr. Macdonald may be able to submit the consultation fee to PPO insurances for reimbursement – contact our office for more information.