East Tennesseans are familiar with allergies. Most of us suffer from them on a seasonal basis at least. Allergies not only affect breathing, but also the quality of sleep – and we’re not just talking about feeling a little congested. “Patients who suffer from allergic rhinitis often have poor sleep quality. Sleep disordered breathing is a spectrum from snoring all the way to obstructive sleep apnea. About 30 percent of Americans snore, and about 20 percent of those snore due to obstructive sleep apnea. That leaves a good percentage with some other sleep disordered breathing issue,” said Dr. Bryan Tigner with Blount Memorial Physicians Group – Ear, Nose and Throat.
Addressing airflow complications in the nasal airway in patients with allergies can greatly improve sleep disordered breathing. Allergens irritate the tissue in the nasal passages and can make you uncomfortable, interfering not only with getting to sleep, but staying asleep. “A lot of the inflammatory mediators that are released during an allergic response, like histamines or leukotrienes, are elevated during sleep naturally, so those patients primed with repeated allergy exposures will have a potentially higher release of these during sleep, leading to increased nasal congestion,” Tigner explained.
Often, medication or immunotherapy, such as an allergy shot, is prescribed to try to tame allergies, but when these kinds of traditional first-line methods aren’t effective and a structural defect is present, surgical options may be needed to ease congestion and improve sleep quality. Ear, nose and throat specialists, or ENTs, are specifically trained in surgical techniques of the head and neck, allowing them to go one step further than a traditional primary care physician or allergist in treating sleep disordered breathing. A few options available at Blount Memorial Physicians Group – Ear, Nose and Throat are turbinate reduction, septoplasty and radiofrequency ablation.
Turbinate reduction involves removing tissue around the turbinate bones in the nose to make breathing easier. The success rate for this procedure is approximately 82 percent. Septoplasty is a minor, low-risk procedure to correct a deviated septum and increase airflow through the nasal airway, with success rates ranging around 85 percent. “Another option is radiofrequency ablation. High on the septum is a nasal swell body that can become chronically inflamed, narrowing the valve and creating breathing issues. Radiofrequency ablation shrinks those inflamed tissues to open up the airway and increase air through the nose. Structural features can be fixed with surgery and greatly improve sleep quality,” Tigner said. For those with obstructive sleep apnea and using a CPAP, addressing nasal airway issues also increases CPAP tolerance. With the patient breathing easier through the nose, the respiratory therapist can turn down the pressure required to get past the original obstruction.
Although not all sleep disordered breathing problems require surgery, it’s worth getting an ENT to take a look at what’s going on and recommend ways to improve how well you breathe and sleep. “As humans, we are designed to breathe through our noses, and our noses are a filter for our entire body. That’s why it’s important if you have an issue to see an ENT and get treatment,” Tigner added.
To make an appointment with Dr. Tigner at Blount Memorial Physicians Group – Ear, Nose and Throat, call 865-238-6460.