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Procedure Helps Some to Snore No More


It was bad enough that firefighter Doug Whalen's snoring made him persona non grata in his bedroom.

But when the guys at the firehouse kicked him out of the bunk room and made him move his cot behind the firetruck in the bay, the Newington, Conn., man really began to feel self-conscious.

Whalen is among 40 million people in the United States--and an untold number of their sleep partners--vexed by habitual snoring.

For about half of these people, snoring is a symptom of a more dangerous condition called sleep apnea, a disorder in which the person stops breathing several times an hour during sleep.

But for the others, such as Whalen, snoring is more of an annoyance, caused when the floppy tissue in the airway relaxes too much during sleep and vibrates, creating the sound of a lawn mower.

The nightly buzz didn't bother Whalen, a 44-year-old father of two. But it drove his wife crazy.

"It was bad. I felt like I couldn't get a good night's sleep," said Marie Whalen, Doug's wife of 15 years. "I spent the whole night saying, 'Roll over, roll over.' "

So when she heard about a relatively new surgical treatment for nuisance snoring, she asked her husband to make an appointment.

The process, called somnoplasty, was approved by the U.S. Food and Drug Administration in 1997.

Doctors at the University of Connecticut Health Center in Farmington started doing somnoplasty in August 1999, and Whalen was the first patient. After the first treatment, Marie enjoyed silent nights for about a year.

But as expected, Doug's snoring eventually returned, and last week he had a repeat treatment. Doctors and Somnus Medical Technologies, the California company that makes the somnoplasty equipment, agree that two treatments are often necessary to eliminate snoring permanently.

Late on a Friday afternoon, Whalen sat in a chair at the office of Dr. Denis Lafreniere as the doctor numbed Whalen's mouth with a local anesthetic. Lafreniere then used a device resembling a small plastic pistol with a needlelike probe at the end to make three holes in the soft tissue at the opening of Whalen's throat, just behind the uvula, the flap of skin that dangles at the back of the mouth.

The needle generates radio-frequency energy that creates heat. The device literally cooks three jellybean-sized areas at the opening of the throat. The little wounds heal during the next two months, creating scar tissue that tightens up the tissue in the upper airway, eliminating the floppiness and vibration that cause snoring.

The process took about a half-hour, and Whalen said the pain was minimal. After the first surgery, he said, his throat was sore for two days.

Dr. Jerome Sugar, an ear, nose and throat specialist in Waterbury and past president of the Connecticut Ear, Nose and Throat Society, said somnoplasty is not for everybody.

He said he has done hundreds of the procedures but estimates that fewer than 10% of the patients he sees for snoring complaints are good candidates.

Before considering surgery, Sugar said, patients must understand why they snore and should try lifestyle changes, such as not sleeping on their backs, losing weight and avoiding alcohol before bedtime.

Somnoplasty costs about $1,500 to $1,800, which includes repeat treatments when necessary. Because the procedure is not covered by insurance, Sugar said, the simpler alternatives might be cheaper, as well as safer.

Doctors also cautioned that anybody with habitual snoring should be thoroughly checked to ensure they do not have sleep apnea.

Sleep apnea can be an underlying cause of heart disease, stroke and, in rare cases, even death, if blood oxygen drops enough to trigger an irregular heart rhythm.

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