Case Challenge: Evaluating and Managing the Many Variations of Snoring

Gordon H. Sun, MD, MS

Disclosures

October 19, 2018

Do Oral Appliances to Treat Snoring Really Work?

A recently married 39-year-old male mechanic presented to his primary care physician, at the urging of his wife, for evaluation of a several-year history of chronic snoring. The patient denied daytime sleepiness or difficulty breathing or swallowing. His medical history was unremarkable, and he had no known medical conditions. Regarding his social history, the patient noted that he was a nonsmoker and consumed alcohol intermittently.

The patient's vital signs were normal. A thorough physical examination of the head and neck demonstrated patent nostrils; 2+ tonsils bilaterally; midline uvula; normal-appearing soft palate and tongue; and a broad, supple neck. A polysomnogram (PSG) revealed an apnea-hypopnea index (AHI) score of three events per hour, which was within normal limits.

The patient was referred to an otolaryngologist for nasopharyngoscopy and laryngoscopy, which found no significant upper-airway obstructive lesions or soft-tissue redundancy. He was subsequently referred to a local dentist with expertise in fashioning oral appliances (OAs) to reduce snoring.

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