When we discuss the various procedures used at Sereno Center to mitigate or eliminate snoring with a patient, we often recommend a combination of procedures to obtain the best possible result.  Frequently, this will include a procedure known as Radiofrequency Nasal Turbinate Reduction (RNTR) using Coblation technology.

RNTR involves treating the patient’s nasal airway using coblation radio frequency energy to gently reduce the size of the patient’s enlarged turbinates.  Turbinates are balloon shaped fleshy membranes, shaped like a top, located in the nasal airway (see diagram).  RNTR allows for substantial improvement in airflow through the nose, resulting in less vibration (which causes snoring), increased energy levels, and possible improvement in sleep apnea as well.  RNTR is also highly effective at reducing nasal congestion due to allergies.

This virtually painless, FDA approved procedure is often performed in a single outpatient visit, in less than 10 minutes, using local anesthetic.  There are no known major complications resulting from the treatment.  Recovery time is nearly non-existent, and most patients continue on with their day after the procedure.  

Side effects are very minimal, and may occasionally include temporary nasal congestion or nose bleed.

The question is:  does RNTR work?  Recent medical literature has reported consistent success rates for RNTR between 85 and 94% in significantly improving air flow to the nose, with the average study citing an approximately 90% success rate.^1,2

Long-term results have also been excellent.  One study which followed patients for 20 months after their RNTR procedure sums it up best, “We have shown that Radio Frequency Turbinate Reduction can produce a long-term improvement on symptoms and on maintenance of nasal function.”³ At Sereno, our observed success rate has been in excess of 90% and we perform these procedures daily.  We have observed long-term success consistent with the above.

In summary, RNTR can be a very effective therapy to help combat snoring and sleep apnea (as well as other conditions such as allergies).  Snoring and sleep apnea are complex, multi-factorial conditions often caused by more than one area of the anatomy.  Each patient is different.  When used in combination with other effective, minimally invasive techniques at Sereno Center, we can make significant improvements in the quality of our patients’ lives and sleep.

Many times we are asked by our patients and prospective patients how important sleep actually is. At Sereno, The Center for Snoring Solutions, we believe sleep is a critical element to your general well-being, your health and your relationships. And we’re not alone. A recent national sleep foundation poll finds that lack of sleep substantially increases your risk for Diabetes, Obesity, Hypertension, Heart-attack, and can even decrease your life span¹. Unsurprisingly, some of the most common causes of sleep deprivation are snoring or sleep apnea. This usually affects both the patient and their bed-partner.

Most people don’t realize, however, how profoundly lack of sleep can affect your performance at work, your relationships with friends and loved ones, your wallet in terms of actual economic cost and your overall happiness.

Below is a summary of the highlights from a National Sleep Foundation study completed in 2010¹.

• 65-70% (about two-thirds) agreed that not getting enough sleep impacts or affects their ability to do everyday activities.
• 17-23% (two in five) indicated that their intimate/sexual relationships had been affected because they were too sleepy.
• 51-62% (over half) of all respondents agreed that not getting enough sleep impacts their relationships with family or friends.
• 57-72% (almost six in ten) agreed that not getting enough sleep impacts their job performance.
• More than one-third of all respondents completely agree that not getting enough sleep can affect your performance at work or duties at home.
• More than three-fourths of respondents agreed that insufficient or poor sleep is associated with health problems.
• 19-24% (two in ten) of all respondents say they missed events at least one day in the past month because they were too sleepy or had a sleep problem.
• 25-38% of all respondents experience a disturbance in their sleep due to concerns they have.
• 28-39% (one-third) of all respondents reported that their sleep needs are not being met on workdays/weekdays.
• 8-20% of all respondents reported that they rarely or never get a good night’s sleep.

Sereno is at the forefront of advancements in sleep medicine that are helping patients resolve their snoring and sleep apnea conditions. While more traditional therapies treat the symptoms of snoring or sleep apnea, and not the underlying anatomical cause, or treat the conditions in ways that are extremely invasive or difficult to comply with, Sereno focuses on an approach that utilizes safe, effective, simple minimally invasive and virtually painless snoring solutions that are designed to permanently alleviate these conditions. Our custom treatment options include nasal turbinate reduction, uvulectomy and the Pillar Procedure.

Overwhelming evidence suggests most patients have more than one anatomical or lifestyle factor contributing to their snoring or sleep apnea condition. Technology now exists that supports a minimally invasive approach to achieve effective results. These solutions are virtually painless, designed to be permanent, and have efficacy rates in excess of 90%. For more information on how Sereno, The Center for Snoring Solutions can help you sleep better, please call us at 415.525.8400, stop by our snoring clinic in San Francisco or visit our website at www.serenocenter.com

One of the most common questions our patients ask concerns the long-term efficacy of palatal implants.  In other words, is there significant evidence that procedures such as the Pillar Procedure are effective at reducing snoring over an extended period?

In the study “Long-Term Results of Palatal Implants for Primary Snoring” conducted in 2004, the year the Pillar Procedure obtained FDA approval, researchers followed 40 healthy adult patients who had been treated with a less advanced version (than the current procedure) of the Pillar Procedure for snoring over a one year period following their treatment.  Researchers were specifically attempting to determine the safety and efficacy of the treatment over time.

Each patient in the study received 3 implants (we now know that 4-6 implants is optimal) after a thorough clinical, polysomnographic and endoscopic examination.  Snoring and daytime sleepiness were assessed prior to receiving the procedure, as well as 90, 180, and 360 days thereafter.  Objective data were obtained by polysomnography and SNAP-recording before and 90 days after treatment.

The results after 1 year?  

All implants were placed without any complications. Among the patients treated, zero reported complications.

Both snoring (Visual-Analogue-Scale) and daytime sleepiness (Epworth-Sleepiness-Scale) were substantially reduced after patients received implants.  

More recent evidence suggests that the best results are achieved when the conditions of snoring and sleep apnea are treated as multi-level, complex problems.  That is, the soft palate contributes to snoring nearly 80% of the time, but there are usually other factors contributing to snoring as well.  That’s why at Sereno, The Center for Snoring Solutions, we perform procedures like the Pillar Procedure in conjunction with other minimally invasive procedures, to develop a comprehensive treatment plan, tailored to you.  

During your evaluation at Sereno, our specialized physician will show you the sources of your snoring or sleep apnea condition, using the latest digital imaging technology, and recommend an approach to alleviate it. Our recommended solution can typically be performed in less than 30 minutes, and our efficacy rates have been in excess of 90%.  

For more information, please call us at 415-525-8400 or visit our website at www.serenocenter.com.

The Secret History of Snoring Series
Part 8: The Sonic Locator

Omaha, Nebraska (May, 2010) --  Authorities responding to a house fire made their way through flames and thick smoke to locate and rescue a 54 year old man who remained inside, sleeping in the basement of the house.  After determining that everyone else was safely out of the building, Officer Kenneth Fox entered the house and descended the basement stairs. Unable to see the sleeping victim through the smoke, Officer Fox felt around blindly until he could grab the sleeping victim and lead him to safety outside.

Officer Fox located the victim by following the sound of his snoring.

"Maybe this is a legitimate reason for not receiving treatment -- snoring provides a day or night, all-weather sonic locator beacon, that functions even under extremely smoky conditions and gives your location in the event of an emergency," says Dr. Matthew Mingrone, Medical Director at Sereno, The Center for Snoring Solutions, "but I'd be more willing to bet that it is the 'exception that proves the rule.'  For almost everyone except this 54 year old housefire victim, snoring is an embarrassing, unhealthy, but very treatable condition."

At Sereno, we treat snoring comprehensively with revolutionary, safe, FDA-approved, minimally invasive, virtually painless solutions.  If you are a candidate for a solution, most can be performed in less than 30 minutes in the comfort of our office.  

A few short years ago, only unattractive options existed for patients suffering from these ailments. The most common solutions varied from those difficult to comply with to those that permanently altered your anatomy and were risky and painful to undergo, with low efficacy rates.    

So, are you better off snoring, so you will be easier to find in the event of a fire or other emergency?  Or should you seek a virtually painless, highly effective, medical treatment for snoring?  Maybe you should ask your spouse or bed partner about that.

Sereno, The Opposite of Snoring

You can read more about the article here: Omaha World Herald

The Secret History of Snoring Series
Part 7: Napoleon: Bonjour and Au Revoir

Napoleon Bonaparte.  The name itself stands for political and military success.  Corsican born, Napoleon was a member of Italian nobility whose presence came to dominate the political scene in France, where he eventually became emperor. His unprecedented series of military victories on the European continent is unequaled in modern times. He established the Napoleonic Code, which formalized such tenets of modern thinking as freedom of religion, rule of law regardless of privilege or parentage, and reliance on written law.

In short, a diminutive man of massive accomplishment.

And snorer.

"I'm not sure Sereno could have helped Napoleon enough to change the result at the battle of Waterloo", says Dr. Matthew Mingrone, Medical Director at Sereno, The Center for Snoring Solutions, "but we probably could have put a little more zing into his 'bonjour' if we could have helped him bid 'au revoir' to his snoring. Snoring is closely associated with poor quality sleep, decreased cognitive function, sleep apnea, and many other very serious health conditions such as diabetes, stroke and hypertension.”  

Using up to the minute, FDA approved, minimally invasive, virtually painless medical procedures, Sereno is a medical practice that specializes in treatment of snoring.  In fact, that's all we do.  Our doctors are board certified Otolaryngologists (Ear Nose and Throat Physicians) that specialize in the treatment of snoring and sleep apnea.  If you snore, a visit to Sereno is potentially life changing.

Could we have changed the course of events at Waterloo by treating General Bonaparte's snoring?  "Who's to say," says Dr. Mingrone, "but I'm pretty certain that his army would have slept better."

Sereno, The Opposite of Snoring