Sleep Apnea & Snoring

Sleep apnea and snoring occur when the airway becomes partially or completely blocked during sleep, disrupting breathing and reducing oxygen levels. This can lead to poor-quality sleep, daytime fatigue, cardiovascular strain, and long-term health risks.

At The Medical Group of New Jersey, our ENT specialists provide comprehensive evaluation and treatment to restore safe breathing at night, improve sleep quality, and reduce long-term complications.

Symptom Onset & Initial Evaluation

Sleep apnea may begin gradually and is often overlooked. Common symptoms include:

• Loud or habitual snoring
• Gasping or choking during sleep
• Pauses in breathing (often noticed by a partner)
• Daytime fatigue or trouble concentrating
• Morning headaches
• Dry mouth upon waking
• Irritability or mood changes

During your first visit at The Medical Group of New Jersey, your ENT specialist will take a detailed history, including sleep habits, lifestyle factors, and existing medical conditions (such as obesity, nasal obstruction, or thyroid disease). A physical exam may include:

• Airway and nasal passage evaluation
• Examination of the tonsils, tongue, and jaw structure
• Blood pressure and BMI assessment

To help identify your risk level, a validated screening tool known as STOP-Bang may be used, which stands for:

• Snoring
• Tiredness during the daytime
• Observed apneas
• Pressure (high blood pressure)
• Body mass index (BMI) > 35
• Age > 50
• Neck circumference > 16 inches (women) / 17 inches (men)
• Gender (male sex is associated with higher risk)

STOP-Bang is a screening tool, not a diagnostic test, that helps determine whether a person is at low, intermediate, or high risk for sleep apnea. A high score indicates the need for a formal sleep study, but it cannot diagnose sleep apnea by itself.

Diagnosis & Risk Assessment

Diagnosis typically requires both a physical exam and sleep-focused testing.

Your ENT may recommend:

• Polysomnography (Sleep Study): An overnight study performed in a sleep center that measures breathing, oxygen levels, brain waves, and heart rhythm.
• Home Sleep Apnea Testing (HSAT): A convenient at-home test for select patients, measuring airflow, oxygen levels, and respiratory effort.

Additional Evaluations, as needed:

• Nasal endoscopy: To assess obstruction or structural issues
• Imaging (if needed): For nasal or throat anatomy
• Epworth Sleepiness Scale: A questionnaire that measures daytime sleepiness

Common Risk Factors

Identifying risk factors allows your ENT team to personalize your treatment plan. Factors that your ENT will assess include:

• Obesity or recent weight gain
• Family history of sleep apnea
• Enlarged tonsils or adenoids
• Nasal congestion or chronic sinus disease
• Smoking or alcohol use
• Large neck circumference
• Jaw or palate structure

Treatment & Management

Treatment focuses on keeping the airway open during sleep and reducing contributing factors. Your plan may include lifestyle changes, medical therapy, or surgical options, depending on severity.

Lifestyle & Behavioral Approaches

• Weight loss when appropriate
• Avoiding alcohol before bedtime
• Side-sleeping positioning
• Treating nasal allergies or sinus disease
• Improving sleep hygiene and routine

These strategies help reduce airway collapse and snoring.

Positive Airway Pressure Therapy

• For moderate to severe obstructive sleep apnea, the most effective treatment is Continuous Positive Airway Pressure (CPAP): Delivers steady air pressure to keep the airway open.
• Bi-level Positive Airway Pressure (BiPAP/BPAP): Used when CPAP alone is not tolerated or effective.

The Medical Group of New Jersey provides guidance on mask fit, comfort settings, and troubleshooting to improve long-term success.

Oral Appliance Therapy

• Custom-fitted dental devices reposition the jaw or tongue to keep the airway open. These are often used for mild to moderate sleep apnea or patients who cannot tolerate CPAP therapy.

Your ENT may coordinate care with dental sleep specialists when needed.

Surgical Options

• When anatomical issues significantly narrow the airway, surgical treatment may be recommended. Common procedures include tonsillectomy for enlarged tonsils.
• Nasal surgery (septoplasty or turbinate reduction).
• Uvulopalatopharyngoplasty (UPPP): Tightens tissues in the throat and removes excess tissue causing obstruction.
• Tongue-base reduction procedures.
• Inspire® hypoglossal nerve stimulation: An implantable device for select patients with moderate to severe sleep apnea.

Your ENT will discuss risks, benefits, and expected outcomes to help you choose the best option.

Monitoring & Follow-Up

Ongoing follow-up ensures long-term success and symptom improvement. Your ENT specialist may schedule:

• Review of CPAP/BiPAP usage and comfort
• Repeat sleep testing to evaluate treatment effectiveness
• Monitoring for snoring recurrence
• Evaluation of nasal or throat symptoms
• Coordination with sleep medicine and primary care
• Post-surgical follow-up if a procedure is performed

Sleep apnea is a chronic condition, and long-term monitoring helps prevent complications.

By partnering with your sleep and ENT specialists at The Medical Group of New Jersey, many patients achieve lasting relief and reduce long-term risks such as heart disease, high blood pressure, and stroke.