My boyfriend had surgery to correct deviated septum. Why is he still snoring after surgery?

Question

My boyfriend had surgery to correct his deviated septum. It's been about 6 months since surgery and his snoring is very slightly lessened. His breathing is much better but he still has a very loud snore. Are there any products that can help this? We were thinking about doing an anti snore chin strap, but are afraid of the potential negatives that can have. We've tried Neti pots, he uses Flounase every day, and we've tried other basic solutions. Please help!

Franklin Douglis, MD · Answer

Sroberts0316 - Neti pots are terrific for patients with chronic sinusitis or allergic rhinitis. Flonase is a steroid preparation which is useful for patients with internal nasal swelling which is usually (but not always) from allergy.  Usually nasal obstruction is relieved after septal surgery unless he has severe allergies which need to be addressed.Snoring is a warning sign and the main symptom of Obstructive Sleep Apnea (OSA).  People who have OSA have 3 times the incidence of stroke and heart attacks, and 7 times the over all mortality rate of people without OSA.  These risk factors go away with treatment.   Therefore it is very important to make the diagnosis and treat accordingly! OSA can be caused by a deviated septum.   In fact a study done on medical students many years ago showed that when their noses were blocked they all developed OSA.  OSA seems to be most common in overweight men who are over 40.  Generally a neck size over 16 1/2 " is strongly associated with OSA.  Although that is the rule, I saw 2 patient's in their 20's this week who were slender and had OSA.If your boyfriend has any of the other symptoms of OSA :Excessive daytime slepiness Drowsy while driving, Falling asleep while reading or watching TVWaking with a HeadacheTrouble waking in the morningOr associated medical conditions such as Obesity, Diabetes, Elevated Blood Pressure- he should have a sleep study to check for OSA.  If the study is negative or shows mild OSA then there are many  treatment options open to him including a dental device to  help open his airway and surgical procedures to do the same.  In more severe cases, a Continuous Positive Airway Pressure (CPAP) machine may be necessary.  Most patients with OSA are overweight and losing the weight can eliminate both the OSA and the snoring.Unfortunately OSA causes the body to release a hormone which causes the patient to crave sweet, fatty foods (like donuts).  I have found that patients are almost never successful in losing weight until their OSA is addressed with a CPAP machine.  Once they lose the weight many people do not need the machine anymore.  We have an effective rapid weight loss system in my office but this is a different topic The best options are determined by the results of the Sleep Study and a good physical exam, including an examination of the upper airway by a physician familiar with the diagnosis and treatment of upper airway issues.  Every patient is different and effective treatment must be tailored to fit the individual.Franklin Douglis MD Board Certified in  Otolaryngology (ENT) and Sleep Medicine.

William Marshall Guy, MD · Answer

Hello Sroberts0316,There are many reasons to snore.  The fact that your boyfriends nasal breathing has improved following surgery but he still snores indicate it was not likely caused by a deviated septum (but may have been exacerbated by one).  Snoring is caused by vibration of the uvula which is the dangly thing at the back of the mouth and laxity of the soft palate (which is what the uvula connects to).  There are several surgical options and non surgical options.  The first thing would be to determine if he was actually having episodes where he stopped breathing, known as apnea.  If this is occurring then insurance may cover the surgical options.  If he is having apnea, then a CPAP machine which delivers pressurized oxygen to keep everything open is an option.  The drawback is the machine can be a little noisy so partners don't always like it.  The benefit is the nose is regular instead of the irregular sound of snoring so it almost acts like white noise.  If he is overweight then weight loss can improve and even eliminate snoring.  Also avoid any sedatives such as alcohol or sleeping pills as these worsen snoring.  Side sleeping can also help but changing a sleep position can be quite difficult (one patient's wife had sewn a tennis ball to the back of his night shirt so if he ever rolled on his back it would wake him up forcing him to learn to side sleep).  From a surgical perspective there are palate firming procedures where implants are placed buy my favorite is referred to as the uvulopalatopharyngoplasty (UPPP).  This can be very effective at eliminating snoring and helping if sleep apnea is present.  The risks are usually minimal but should be discussed with your surgeon prior to proceeding with anything.  If he is having sleep apnea then it really should be addressed as there are many long term complications that can develop if not treated.  I hope this helps and good luck.

My boyfriend had surgery to correct deviated septum. Why is he still snoring after surgery?

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My boyfriend had surgery to correct deviated septum. Why is he still snoring after surgery?

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Everything you need to know about Septoplasty

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