Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Sleep Breath. 2010 Dec;14(4):317-21. doi: 10.1007/s11325-010-0389-5. Epub 2010 Jul 18.
Snoring has received increased attention over the last years. Given its high prevalence and its impact on quality of life, diagnosis and treatment of snoring are of major importance.
This guideline aims to promote high-quality care by medical specialists for adults who snore.
Before every intervention, a medical history, clinical examination and sleep test need to be performed.
There is no need to treat snoring unless requested by the snorer. Invasive treatments should be selected with care; for surgical treatment, minimally invasive procedures are preferred. Weight reduction; the avoidance of sleeping pills, alcohol and nicotine; and a regular sleep-wake cycle can be recommended, although convincing evidence is lacking. Since currently, there is not enough evidence to confirm the effectiveness of muscle stimulation or other forms of muscle training, these treatments cannot be recommended. Snoring can be treated successfully with intraoral devices, but it is essential to select suitable subjects. Devices preventing sleep in the supine position can also be helpful in selected cases. The data on the success rates of surgical intervention are often limited to short-term follow-up studies, and not all interventions have been sufficiently evaluated. The techniques used to treat nasal obstruction in snorers are identical to those used for general nasal obstruction. Nasal surgery is only indicated when subjects complain about nasal obstruction. A significant amount of data is available for laser-assisted resection of excessive mucosa; however, resections can be performed with other tools. The efficacy of radiofrequency surgery at the soft palate has been documented in placebo-controlled trials. Soft palate implants can reduce snoring. Tonsillectomy or uvulopalatopharyngoplasty should be selected with care, especially as less invasive alternatives are available.
近年来，打鼾受到了越来越多的关注。鉴于其高发病率及其对生活质量的影响，对打鼾的诊断和治疗至关重要。
本指南旨在通过医学专家为打鼾的成年人提供高质量的护理。
在进行任何干预之前，需要进行病史、临床检查和睡眠测试。
除非打鼾者要求，否则无需治疗打鼾。应谨慎选择侵入性治疗；对于手术治疗，首选微创手术。可以推荐减肥、避免使用安眠药、酒精和尼古丁以及保持规律的睡眠-觉醒周期，尽管缺乏令人信服的证据。由于目前尚无足够证据证实肌肉刺激或其他形式的肌肉训练的有效性，因此不能推荐这些治疗方法。口腔内装置可成功治疗打鼾，但选择合适的患者至关重要。在某些情况下，防止仰卧位睡眠的装置也可能有帮助。手术干预成功率的数据通常限于短期随访研究，并非所有干预措施都得到了充分评估。用于治疗打鼾者鼻阻塞的技术与用于一般鼻阻塞的技术相同。只有当患者抱怨鼻塞时才需要进行鼻手术。激光辅助切除过多的黏膜有大量数据支持；然而，也可以使用其他工具进行切除。射频手术治疗软腭的疗效已在安慰剂对照试验中得到证实。软腭植入物可减少打鼾。扁桃体切除术或悬雍垂腭咽成形术应谨慎选择，尤其是因为有更微创的替代方法。
