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Snoring During Pregnancy – What Helps?

By Current News 50 Comments

By Dr Murray Grossan

Obviously partners prefer that any woman not snore, but does it affect pregnancy?

According to a large study from Ann Arbor, Mi, entitled, “Snoring during pregnancy and delivery outcome,” snoring can have a major effect on both mother and child.

  • Snoring increases risk of pre-eclampsia and high blood pressure in pregnancy.
  • Snoring increased the incidence of smaller babies and had a higher risk of elective and emergency surgery.

Snoring or Sleep Apnea

There is an important difference between simple snoring and sleep apnea. In simple snoring, there are no periods where the air passage is blocked, so that no air gets into the body. If the snoring sound wakes up the whole family, but the woman continues to get air into and out of the lungs, then we don’t have sleep apnea. Sleep apnea means actual cessation of air getting to the lungs; doctors measure the periods of time when the patient is not breathing and air isn’t getting to the brain.

If the woman snored before pregnancy and continued during pregnancy, the risks were higher than if she hadn’t snored previously.

Smaller Babies

Because of the serious possibility of a smaller baby with the snoring, it is important to recognize the problem and prevent these complications. One solution is the use of CPAP.

CPAP stands for Continuous Positive Airway Pressure.  Here, a type of mask is applied, and a device delivers air at a pressure to overcome the airway blockage. This works well to overcome sleep apnea. However, not all patients can tolerate the device.

Clear Snoring Before Pregnancy

If someone has significant snoring and is planning to become pregnant, it would be ideal to get evaluated before pregnancy. At Tower E.N.T. we often see persons who snore, and the solution may be as simple as a ten cent tape to lift the nasal tip and open the airway, or a 50 cent tennis ball sewed to the back of a T shirt to encourage sleeping on the side!

At Tower E.N.T. we have experience on determining if an exercise of saying “A,E, I, O, U,” while your tongue is touching your hard palate is all you may need.

Or, your solution may be as simple as blowing up balloons!

Because Dr. Martin Hopp and the other Tower E.N.T. doctors have taught snoring subjects to other doctors, the patient can be confident that the simplest solution will be presented.

Snoring Complications

When there is interruption of flow of air to the body, significant complications can occur. These include:

  • Lack of REM sleep
  • Fatigue next day
  • Falling asleep during the day
  • Hypertension
  • Overweight

Avoid Weight Gain

Because of the fatigue, persons overeat in order to get their work done. Eating excess adds more weight and fat to the soft palate and the throat tissues and makes snoring worse. Keeping proper weight during pregnancy is always a problem: if snoring is present this makes keeping proper weight much more difficult because of the fatigue factor. This is why serious snoring should be treated early to prevent unnecessary weight gain.

The Heavy Soft Palate Blocks Breathing

Snoring due to fatty soft palate can be helped by sleeping on the side. This position puts the soft palate forward to open the air passage.  If nasal congestion or postnasal drip is present, this can be helped by pulse-wave saline irrigation that restores nasal cilia function. For flabby throat tissue, the same device, The Hydo Pulse™ Nasal/Sinus Irrigator contains a throat irrigator that is used to reduce enlarged tonsil and throat tissue to improve airway.  Other aids to snoring include sleeping on the side, or head elevated, blowing trumpet or hard balloon, and lifting the nasal tip to open the nasal valve.

Because you overeat when you snore, clearing this problem may be the key to helping weight control during pregnancy.

The study of snoring in pregnancy is detailed in journal, Sleep, “Snoring during pregnancy and delivery outcomes”. Vol .36,No.11, 2013 by Louise O’Brien

Questions? Feel free to contact Dr Martin Hopp and other members of Tower E.N.T. at 310 657 7704

ADHD in Children. Or is it Snoring? –Part II

By Current News 2,704 Comments

By Dr Murray Grossan

Some children with severe snoring show poor growth. This can occur because the nose and throat are obstructed so that eating is tasteless and uncomfortable. Recall when your nose is plugged; the savory hamburger has no real taste because you can’t smell it with a plugged up nose. Worse, continued snoring can change the physiology and make snoring worse. For example, obstructive snoring can develop into acid reflux.  It can even affect the shape of the chest.

Note that when a child snores from age 4 to 5, that is about 20% of her entire life span; the important part in growing and learning. Constant mouth breathing can effect the jaw/face development and may necessitate the need for orthodonture.

At Tower E.N.T. we have  heard this scenario for years: “Before she snored, she was sweet, laughing, with nice breath. Now she doesn’t smile, she is cranky, inattentive, tired and sleepy. She is not thriving. Teachers complain of her poor work.”

For the snoring child, therapy consists of reducing nasal blockage and reducing blockage from enlarged tonsils and adenoids. Typically:

Judy S. age 6 was seen because of snoring, and poor appetite. Mother described her being cranky and falling asleep in class. On examination she showed sinus infection and enlarged adenoids. She was placed on Hydro Pulse™ Sinus  irrigation and Clear.ease lozenges.  Her nasal blockage cleared and her adenoids shrank so she no longer had any sleep breathing problem.

William age five was seen for snoring and occasional wheezing. He showed nasal blockage and enlarged adenoids. Nasal tissue showed allergy. He was positive to dust and pollen on skin tests; he was given allergy desensitization. His allergy cleared and so did his snoring. His behavior problems also cleared.

Diagnosing obstructive breathing in sleep can be done by thorough ear nose and throat examination and careful history. Clearing a sinus infection allows the adenoids to shrink.

Often parents are told not to worry about the child who snores, since they will outgrow this. At Tower E.N.T. we feel that each case must be treated for best health. This is why we take a full history and evaluate the whole child.

ADHD in Children. Or is it Snoring?–Part I

By Current News 1,017 Comments

By Dr Murray Grossan

Recent studies have pointed to behavior problems, inattention, and crankiness in children as part of the ADHD syndrome (Attention Deficit Hyperactivity Disorder.)  However these behaviors are also seen in children who snore. Even among children expertly diagnosed ADHD, some cleared up their ADHD when the snoring was relieved.

In E.N.T. practice, it is common to see a child who snores and doesn’t sleep well. They are cranky and inattentive, fall asleep in class and don’t smile much. When the snoring is cleared, many of those problems clear up.

In one study, after tonsillectomy and adenoidectomy done for snoring and mouth breathing, 50% of the children who were diagnosed ADHD before surgery, no longer had symptoms.
Thus, a child with loud snoring that exhibits ADHD type behavior may be simply sleep deprived and may recover when the sleep problem is corrected, even when the tests are positive for this diagnosis!

Snoring in children has been a concern for years. Snoring may be a sign of obstructive sleep disorder, where the breathing passage is blocked and less air/oxygen gets to the body.

Occasional snoring due to a cold is not a problem. Of concern is the constant loud snoring, the child that gasps for breath in sleep, or the periods when the breathing actually stops in sleep.

Common causes of snoring include:
•    Allergy
•    Sinus infection
•    Enlarged adenoids
•    Enlarged tonsils
•    Acid reflux

The snoring child who doesn’t get good sleep often shows:
•    Irritability
•    Unpleasant breath
•    Poor attention
•    School difficulty
•    Poor growth
•    Poor appetite
•    Crankiness
•    Inadequate physical activity
•    Fall asleep in daytime

We’ll have more on this next week. Enjoy the holiday!