Snoring and Sleep Apnea

What is Sleep Apnea?

Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.

Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.
Sleep apnea usually is a chronic (ongoing) condition that disrupts your sleep. When your breathing pauses or becomes shallow, you’ll often move out of deep sleep and into light sleep.

As a result, the quality of your sleep is poor, which makes you tired during the day. Sleep apnea is a leading cause of excessive daytime sleepiness.

Signs and Symptoms of Sleep Apnea

One of the most common signs of obstructive sleep apnea is loud and chronic (ongoing) snoring. Pauses may occur in the snoring. Choking or gasping may follow the pauses. You may have many brief drops in the oxygen levels in your blood which is not healthy for your body.

The snoring usually is loudest when you sleep on your back; it might be less noisy when you turn on your side. You might not snore every night. Over time, however, the snoring can happen more often and get louder.

You’re asleep when the snoring or gasping happens. You likely won’t know that you’re having problems breathing or be able to judge how severe the problem is. A family member or bed partner will often notice these problems before you do.

Not everyone who snores has sleep apnea.

Another common sign of sleep apnea is fighting sleepiness during the day, at work, or while driving. You may find yourself rapidly falling asleep during the quiet moments of the day when you’re not active. Even if you don’t have daytime sleepiness, talk with your doctor if you have problems breathing during sleep.

Others signs and symptoms of sleep apnea include:

  • Morning headaches
  • Daytime fatigue and sleepiness
  • Memory or learning problems and not being able to concentrate
  • Feeling irritable, depressed, or having mood swings or personality changes
  • Waking up frequently to urinate
  • Dry mouth or sore throat when you wake up

How is Obstructive Sleep Apnea (OSA) Diagnosed?

Dr. Bublik and his staff at Southern California ENT and Allergy Associates, who serve the greater Los Angeles and Glendale area will do a complete physical exam and medical history including asking you questions about how you sleep and how you function during the day. As part of the exam, we will check your nose, neck and throat to determine the exact areas of obstruction and possible causes of your sleep apnea. For example, a deviated septum, large turbinates, enlarged tonsils, a long or thick uvula (the tissue that hangs down in the middle in the back of your throat), a floppy soft palate or a large base of tongue can all cause obstruction of your breathing from the upper airway. If Dr. Bublik suspects that you have sleep apnea, you may be scheduled for a sleep test called a sleep study or polysomnography (PSG). A PSG may be performed at a sleep center or at home depending on the severity of your symptoms. During these overnight tests, you are measured for apneas (pauses in your breathing), oxygen levels, snoring, as well as a number of other events.


Continuous Positive Airway Pressure (CPAP):

Continuous positive airway pressure (CPAP) is a mask that patients wear over their nose at night which blows air into the nose and throat at a higher pressure to keep the airway open and reduce snoring and sleep apnea. It is the most common treatment for moderate to severe sleep apnea and is the gold standard for treatment, however most people either do not want to use or cannot tolerate it. Often there is an obstruction in the nose or throat that causes the sleep apnea and makes it harder to breath and also to use the CPAP machine, if the patient chooses that option. If you are one of the many who cannot tolerate CPAP for one reason or another and you have mild to moderate sleep apnea you may be a candidate for one of the surgical treatment options that Dr. Bublik and the physicians at Southern California ENT and Allergy Associates in Los Angeles, Beverly Hills and Glendale utilize listed below, which include in-office procedures which are minimally invasive, painless and have little to no downtime.


The septum is the midline structure of the nose. It is made of bone and cartilage and divides the two sides. It can be deviated to one side, completely blocking one side of the nose or be s-shaped causing bilateral obstruction in patients. Patients usually acquire a deviated septum during their teenage growth spurt when the nose grows but is limited by the space provided. This causes the septum to bend into the nose or form a bump on top of the nose. In addition, nasal trauma can cause the septum to shift. Dr. Bublik and the doctors at Southern California ENT and Allergy Associates, who serve the Greater Los Angeles, Beverly Hills and Glendale area perform septoplasty in a minimally invasively fashion through the use of a small camera called an endoscopic. There is no bruising or incisions on the outside of the nose and the nose is not “packed” as was done in the past. . Often times, it is combined with turbinate surgery to enlarge the nasal airways and improve your breathing. A septoplasty by itself does not change the shape or look of the nose. Some patients desire a cosmetic change to the nose as well, which can be done at the same time. Dr. Bublik is a world renowned rhinoplasty and nasal surgeon and specializes in the Complete Nose Job, which addresses both the function and appearance of the nose in one surgery.

Submucosal Resection of Inferior Turbinates

The turbinates are long and narrow tissue with bone inside that protrude into the nasal cavity and when enlarged can obstruct the breathing passage of the nose causing snoring and sleep apnea. There are 3 sets of turbinates on each side of the nose, but the most inferior set is responsible for nasal congestion and is termed the inferior turbinates. During this procedure the bone expanding the turbinates on the inside is shaved down allowing for significant long-term reduction in the size of the turbinates. The turbinates can be reduced with multiple different techniques and either in the office or under general anesthesia in the operating room:

  • IN-OFFICE: with radio frequency ablation (Coblation) or Submucosal resection of the turbinates.
  • GENERAL ANESTHESIA: Submucosal resection of the inferior turbinates when done under general anesthesia often needs to be combined with a septoplasty to repair a deviated septum which can also be the cause of nasal obstruction and resultant sleep apnea.

No matter the location or technique, recovery is painless and is without any nasal packing, so you are breathing through your nose the same day!

Our surgeons in Los Angeles and Glendale will accurately assess the cause of your nasal obstruction and sleep apnea and determine if turbinate surgery will significantly improve breathing through your nose.

Tonsillectomy and Adenoidectomy

Tonsils and Adenoids are the tissues located in back of the nose and throat that can be responsible for blocking the airway and causing sleep apnea symptoms. Dr. Bublik and the physicians at Southern California ENT and Allergy Associates in Los Angeles and Glendale use the latest minimally invasive technology, including coblation to remove the tonsils and adenoids. Tonsillectomy can be performed in adults with sleep apnea and in children. When children under the age of 13 are diagnosed with severe snoring or obstructive sleep apnea, is most cases the enlarged adenoids and tonsils are to blame. As a result these children would benefit from adenoidectomy and tonsillectomy to reduce or cure their sleep apnea and/or snoring. We routinely perform tonsillectomy and adenoidectomy in children and adults with severe snoring and obstructive sleep apnea. Many parents will return months later reporting that their children are no longer snoring, sleeping better and doing better in school and social environments.

Pillar Implant Procedure

The pillar procedure is a minimally-invasive sleep apnea and snoring procedure that stiffens the soft palate through the insertion of small implants and provides relief from symptoms of snoring and mild sleep apnea. This in-office procedure usually takes less than 30 minutes and is performed using local anesthesia for the right patient. This helps reduce the vibration of the soft palate and thereby reduces snoring and the ability of the soft palate to obstruct the airway. Overtime, the body’s natural response integrates the pillars into the soft palate and provides structural integrity and rigidity.

Patients usually return to normal functioning, including and drinking, the same day. Results, however are not seen for at least 2 months. If you feel you may be a candidate, please constact us today. Dr. Bublik and the physicians at Southern California ENT and Allergy Associates, which serve the Los Angeles and Glendale areas, are now utilizing this procedure with fantastic results. Sometimes they perform this procedure in combination with a coblation assisted uvulectomy to target both the anterior and posterior soft palate in patients with a large uvula.


When it comes to painless and minimally invasive, Dr. Bublik and the doctors at Southern California ENT and Allergy Associates, who serve the Greater Los Angeles and Glendale area are always on the cutting edge. Coblation is a procedure which utilizes radiofrequency energy to ablate excess soft tissue (tonsils, turbinates, palate, et cetera). This procedure has been shown to decrease pain and increase recovery. Learn more about Coblation Turbinate Reduction

Uvulopalatopharyngoplasty (UP3/UPPP)

Uvulopalatopharyngoplasty (UPPP) consists of tonsillectomy, reorientation of the anterior and posterior tonsillar pillars, and excision of the uvula and posterior rim of the soft palate. Basically, it is designed to open the back of the throat so more air is delivered while sleeping. This causes more air delivery and less snoring and sleep apnea. This procedure can be quite painful unlike other procedures offered, however in patients with moderate to severe OSA who cannot tolerate CPAP it is necessary.



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