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J R Soc Med. 1990 June; 83(6): 363–367.
PMCID: PMC1292685

Assessment of chronic snorers.


Snorers represent a heterogenous group that require adequate assessment before recommending surgical treatment. There are unfortunately no specific features either in the history or physical examination that might predict those chronic snorers with obstructive sleep apnoea. We have used trained observation together with pulse oximetry ('sleep screening') and fibreoptic nasendoscopy with Muller manoeuvre in our unit to assess snorers. This combination is a reliable means of distinguishing apnoeic patients from simple snorers and determining the level of the obstructing segment. We report our experience in using these methods in the management of 71 chronic snorers. We stress the value of conservative management, and emphasize that obesity, habitual alcohol ingestion and nasal obstruction should be corrected before embarking on pharyngeal surgery.

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Selected References

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  • Koskenvuo M, Kaprio J, Telakivi T, Partinen M, Heikkilä K, Sarna S. Snoring as a risk factor for ischaemic heart disease and stroke in men. Br Med J (Clin Res Ed) 1987 Jan 3;294(6563):16–19. [PMC free article] [PubMed]
  • Jennett S. Snoring and its treatment. Br Med J (Clin Res Ed) 1984 Aug 11;289(6441):335–336. [PMC free article] [PubMed]
  • Simmons FB, Guilleminault C, Miles LE. The palatopharyngoplasty operation for snoring and sleep apnea: an interim report. Otolaryngol Head Neck Surg. 1984 Aug;92(4):375–380. [PubMed]
  • Orr WC, Moran WB. Diagnosis and management of obstructive sleep apnea. A multidisciplinary approach. Arch Otolaryngol. 1985 Sep;111(9):583–588. [PubMed]
  • Clement PA. Committee report on standardization of rhinomanometry. Rhinology. 1984 Sep;22(3):151–155. [PubMed]
  • Lugaresi E, Mondini S, Zucconi M, Montagna P, Cirignotta F. Staging of heavy snorers' disease. A proposal. Bull Eur Physiopathol Respir. 1983 Nov-Dec;19(6):590–594. [PubMed]
  • Gordon AS, Giles ML, Harding DA, Morton RP. Surgery of snoring. J Laryngol Otol. 1986 Nov;100(11):1263–1267. [PubMed]
  • YOUDEN WJ. Index for rating diagnostic tests. Cancer. 1950 Jan;3(1):32–35. [PubMed]
  • Moran WB, Orr WC. Diagnosis and management of obstructive sleep apnea. Part II. Arch Otolaryngol. 1985 Oct;111(10):650–658. [PubMed]
  • Moran WB, Jr, Orr WC, Fixley MS, Wittels EE. Nonhypersomnolent patients with obstructive sleep apnea. Otolaryngol Head Neck Surg. 1984 Dec;92(6):608–610. [PubMed]
  • Borowiecki BD, Sassin JF. Surgical treatment of sleep apnea. Arch Otolaryngol. 1983 Aug;109(8):508–512. [PubMed]
  • Sher AE, Thorpy MJ, Shprintzen RJ, Spielman AJ, Burack B, McGregor PA. Predictive value of Müller maneuver in selection of patients for uvulopalatopharyngoplasty. Laryngoscope. 1985 Dec;95(12):1483–1487. [PubMed]
  • Lyberg T, Krogstad O, Djupesland G. Cephalometric analysis in patients with obstructive sleep apnoea syndrome: II. Soft tissue morphology. J Laryngol Otol. 1989 Mar;103(3):293–297. [PubMed]
  • Hoffmeister JA, Cabatingan O, McKee A. Sleep apnea treated by intestinal bypass. J Maine Med Assoc. 1978 Mar;69(3):72–74. [PubMed]
  • Sugerman HJ, Fairman RP, Lindeman AK, Mathers JA, Greenfield LJ. Gastroplasty for respiratory insufficiency of obesity. Ann Surg. 1981 Jun;193(6):677–685. [PubMed]
  • Harman EM, Wynne JW, Block AJ. The effect of weight loss on sleep-disordered breathing and oxygen desaturation in morbidly obese men. Chest. 1982 Sep;82(3):291–294. [PubMed]
  • Holley HS, Milic-Emili J, Becklake MR, Bates DV. Regional distribution of pulmonary ventilation and perfusion in obesity. J Clin Invest. 1967 Apr;46(4):475–481. [PMC free article] [PubMed]
  • Sharp JT, Barrocas M, Chokroverty S. The cardiorespiratory effects of obesity. Clin Chest Med. 1980 Jan;1(1):103–118. [PubMed]
  • Haponik EF, Smith PL, Bohlman ME, Allen RP, Goldman SM, Bleecker ER. Computerized tomography in obstructive sleep apnea. Correlation of airway size with physiology during sleep and wakefulness. Am Rev Respir Dis. 1983 Feb;127(2):221–226. [PubMed]
  • Brown IG, Bradley TD, Phillipson EA, Zamel N, Hoffstein V. Pharyngeal compliance in snoring subjects with and without obstructive sleep apnea. Am Rev Respir Dis. 1985 Aug;132(2):211–215. [PubMed]
  • Issa FG, Sullivan CE. Alcohol, snoring and sleep apnea. J Neurol Neurosurg Psychiatry. 1982 Apr;45(4):353–359. [PMC free article] [PubMed]
  • Olsen KD, Kern EB, Westbrook PR. Sleep and breathing disturbance secondary to nasal obstruction. Otolaryngol Head Neck Surg. 1981 Sep-Oct;89(5):804–810. [PubMed]
  • Lavie P, Gertner R, Zomer J, Podoshin L. Breathing disorders in sleep associated with "microarousals' in patients with allergic rhinitis. Acta Otolaryngol. 1981 Nov-Dec;92(5-6):529–533. [PubMed]
  • Fujita S, Conway W, Zorick F, Roth T. Surgical correction of anatomic azbnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg. 1981 Nov-Dec;89(6):923–934. [PubMed]
  • Fairbanks DN. Snoring: surgical vs. nonsurgical management. Laryngoscope. 1984 Sep;94(9):1188–1192. [PubMed]

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