How bad was Jim McClendon’s snoring? Bad enough that when his extended family of 12 shared a vacation cabin, by morning 10 people had left to sleep in the yard.
Then there’s truck driver Allen Parker, 31, of Grays Harbor, Wash. His snoring-which sent his wife to sleep in another room, caused him to awake with his heart racing, and left him drowsy on the road-was categorized by those in the know as “worse than Fred Flintstone.”
As for retired deputy marshal Bob Guy, 61, of Camano Island, Wash., snoring “like a machine gun” resulted in poor sleep that left him wrung out by morning, usually with a raging headache.
All three men-and their wives-have found relief in a simple and relatively painless procedure called laser-assisted uvulopalatoplasty, or LAUPP.
LAUPP is a new kind of surgery that requires no hospitalization or general anesthesia, and is estimated to eliminate snoring in about 90 percent of patients. Pioneered in France about six years ago, it was brought to the U.S. about two years ago.
How it’s done: The surgeon uses a hand-held laser to make three small cuts trimming the uvula and soft palate. (The vibrations of the soft palate cause snoring.) The procedure usually is performed in several stages, about a month apart; each time, the surgeon cuts a little more. The cuts scar, causing the tissue to stiffen and shrink, thus elevating the soft palate and creating a more rigid and effective airway. Because it’s stiffer, it causes less vibration, according to Dr. Gregory Chan, one of the Seattle specialists who perform LAUPP. The heat of the laser cauterizes blood vessels and seals nerve endings, eliminating the need for stitches.
Each treatment lasts about 10 to 15 minutes. The number of treatments needed varies with the patient, but three or four visits is typical, says Dr. Eric Pinczower, assistant professor of otolaryngology, who performs LAUPP at the University of Washington.
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Pain? The worst pain is having the shots of local anesthestic. Most patients feel only a little pressure from the laser, though one described a mild stinging. Afterward the patient usually has the equivalent of a sore throat, from mild to severe.
The surgeons who perform it say LAUPP is a huge improvement over the traditional surgery for snoring, which involved cutting out a much larger area of tissue. That surgery posed more of a risk of infection, left complications from the general anesthesia and caused a great deal more pain.
The new procedure is also a lot cheaper; in the Seattle area, costs range from $1,600 to $2,000 (compared with upward of $10,000 to $12,000 with the old operation).
Studies by French researchers have reported a high success rate for people with simple snoring. But critics of the procedure say they want to see long-term studies of effectiveness done in the U.S.
One U.S. study of 300 patients now going on has reported promising results for both sleep apnea and snoring patients.
But Dr. Ralph Pascualy, medical director of the Sleep Disorders Center at Providence Medical Center in Seattle, notes that traditional surgery has been found to be effective for only 50 percent of sleep apnea patients, and since the new procedure takes even less tissue out, it’s hard to see how it could be more effective.
The biggest concern of sleep-disorder specialists is that patients who don’t realize they have sleep apnea, a potentially dangerous condition that involves a cessation of breathing, will cure their snoring without addressing the bigger problem. Snoring is a warning sign for sleep apnea, though it’s possible to have sleep apnea without snoring.
“The question is, with someone who doesn’t meet the criteria for sleep apnea, if we eliminate the snoring, 20 years down the line will he develop into a sleep apnea patient and no one will know it?” Pinczower says.
Doctors say the procedure is not for everyone. For one thing, it depends on your physiology; for another, there are techniques that may work for some to head off or tone down snoring to an acceptable level. Doctors say the best candidates are those for whom snoring is disruptive and who snore in all sleeping positions.