Q.  I have been told that I snore loudly. I wake up tired - even after ten hours of sleep. I toss and turn throughout the night.  I have headaches in the morning. I sleep alone! What is the solution?
A. These are classic signs of sleep apnea, a serious and even deadly condition. Weight loss, CPAP and surgery are possible solutions.  Laser surgery will address your snoring problem by reducing the intensity of the sound by up to 70%.  

Q. How long does the laser procedure take?
A. On the average, this procedure takes less than an hour but including pre-operative preparation; you can expect to be in our center for approximately 2 ½ hours. The procedure is simple done right in our state-of-the-art Bala Cynwyd center. In general, most patients prefer to be sedated during the procedure. Experience of the surgeon has a lot to do not only with how fast the procedure could be done but how well and how precise. We have performed thousands of laser surgery case since 1992. With our changing technology, Dr. Madani has significantly modified the procedure to be performed in a single visit.

Q. How do I know if I have sleep apnea?
A. Normally, patients with sleep apnea may have certain signs and symptoms such as: day time sleepiness, loud snoring, stopped breathing at night, restless sleep, morning headaches, memory loss and nighttime disturbances. However, you may not be aware of your problem, so a sleep study will confirm the presence or absence of apnea. Most sleep studies are done in a sleep center and patients spend the night in a private room. Many large hospitals are equipped with sleep centers. During the study, special sensors record the activity of your heart, lungs and brain; the movements of your muscles; airflow from your nose and mouth; and the oxygen level in your blood. In addition, your body movements may be videotaped while snoring; talking or other noises are recorded. A technician watches the recording on the monitors all night to observe you and make sure there are no problems with the equipment. If you have severe sleep apnea, the technician may provide a device called CPAP (a device that forces room air into your body) that keeps your air passage open and helps you breathe.  CPAP must be used all the time and your compliance in that regard is crucial in the effectiveness of it.

Q. Do I need a sleep study prior to the procedure?
A. Not everyone is required to have a sleep study prior to the procedure. However, a post-operative sleep study is recommended for all patients. During your consultation, in addition to a detailed review of your medical history, a head, neck and oral examination will be done and all of your options will be discussed. Please remember that our procedures will not cure sleep apnea but are designed to reduce the intensity of snoring.

Q. How long is the recovery period?
A. Recovery is incredibly fast.  Patients are able to and encouraged to return to work and resume normal activity the day after the procedure. Patients are expected to have a sore throat for 12-14 days after the surgery. In addition, a soft food diet is recommended during recovery and we would provide a list of soft menu items.

Q. What are the benefits of laser surgery?
A. The benefits of our LA-UPPP procedures are outstanding compared to conventional surgical methods. The procedure is handled on an outpatient basis under a light sedation and local anesthesia. Each treatment is quick and patients are able to return to normal activities the following day. All of this adds up to less discomfort and more convenience for the patient.  In addition and most importantly are the results. Thousands of patients treated since 1992 have reported stable results several years later after surgery. 

Q. What are the side effects of the laser treatment for snoring?
A. Following the procedure, patients can expect to have a moderate to severe sore throat for 12-14 days. Pain medication is prescribed to help alleviate the discomfort.  For the first day and a half, patients should be on a full liquid diet. The second week after surgery, a soft food diet is recommended (fish, oatmeal, potatoes, pasta, eggs, etc.).  We will provide a menu for soft food suggestions. When patients feel ready, they can slowly resume eating regular meals. Dryness of the back of the throat is very common after the procedure indicating an easier airflow in the nasopharynx.  Feeling of lumpiness also may occur in few patients, however both the dryness and lumpiness feeling could be significantly reduced if you chew gum or swallow pushing your tongue to the roof of your mouth as often as you can for a period of four weeks after surgery.  Generally these complications are temporary in nature but may last for several years. Due to the soft food diet, weight loss may occur.

Q. Does this procedure affect the voice in any way?
A. There has not been any report of voice change with our patients. The uvula and soft tissue, which is removed, does not have an impact on the vocal cords. The main purpose of the uvula is to act as a swinging door and protect liquid or food from entering the nasal passage.  However the soft palate is the reflective device that allows the voice to project outward from the mouth.  Traditional UPPP was reportedly associated with over 5% voice changes.  In thousands of cases treated in our center no one has had a voice change directly related to our procedures.

Q. What is the function of the uvula and soft palate?
A. The uvula and soft palate work as a single unit to seal off the nasal passage when you drink or eat. The other function of these two structures is to reflect the sound of your voice out of your mouth rather than your nose. Additionally, they direct food and liquid into your pharynx and esophagus. Patients who have severe post-nasal drip use their tongue and uvula to bring the postnasal phlegm forward to expectorate.  This function will be restored by the swallowing exercise explained in last question. Our extensive experience with laser surgery and the experience of other practitioners with laser surgery have proven that removal of the uvula in patients who suffer from severe snoring would have minimal effect. Once again, the experience of the surgeon is crucial in avoiding complications.

Q. Do any insurance companies cover this procedure?
A. This procedure is performed to treat snoring. Therefore, it is considered cosmetic in nature and not covered by insurance plans. It is just the same if you were to have any other cosmetic procedure (tummy tuck, breast augmentation). We cannot bill your insurance company for this procedure. If the issue is sleep apnea, then your insurance company should cover alternative treatment plans (i.e., a CPAP machine).

Q. What is the cost of the laser procedure?
A. The cost of the laser procedure is $2100.  If you require the nasal Coblation procedure, there is an additional charge of $900(A total charge of $3000).  Keep in mind that the source of snoring could be from the enlarged uvula, elongated soft palate, tonsils, adenoids, and voice box, base of the tongue, narrow airway and/or enlarged nasal passages. In many cases, we can perform both the nasal radiofrequency and the palatal laser surgery (LA-UPPP) and tonsillar radioablation on the same visit.  Once we examine you we would determine which procedure is best for you.  The charge for the nasal radiofrequency is separate from the laser treatment charge.

Q. I do not live near Philadelphia. Can I still have this procedure done at your center?
A. Luckily, Philadelphia is a place worth visiting if you've never been to this historic and beautiful city. Fortunately, the laser procedure can be done in our office and within fifteen minutes.  A traveler can easily plan a two-day trip, have the surgery, and head home the next day.  We usually recommend that traveling patients spend the night following their surgery in a local hotel so we can take a post-operative look at them the following morning before going home. If you decide to travel to our center for your surgery, call our office so we can help with your accommodations.

Q.  I am a great sleeper, when I put my head on the pillow I fall sleep in minutes, but I wake up tired. Why?
A. When you snore, the airway in the back of your throat could be blocked by your tongue or the uvula and cause you to stop breathing.  You may toss and turn all night not even knowing anything about that.  You then miss the crucial REM sleep and wake up tired.

There are other causes besides snoring that causes you to loose sleep.  Excitability, anxiety, nervousness, or the inability to fully relax has caused many people to lose valuable sleep. When sleep is lost, the next day is spent drinking many cups of coffee while stumbling through the day. Consider this vicious cycle. You lose sleep because of interrupted sleep, you're tired, wake up fatigued and not rested and don't do the things that need to get done.  Then at night you feel sleepy while driving, come home and eat dinner and fall sleep right away after half an hour you snore again and having interrupted sleep.  So being a so-called great sleeper may mean that you actually suffer from an illness of sleep apnea. 

Q. Who is affected by snoring?
A. Almost all of us snore one time or other in our lives, but for some it can be much more problematic. This habitual snoring (a person who snores all the times) is more common in males, overweight persons, and usually becomes worse with age.  Not only is it disruptive for the snorer, who can actually awaken him or herself, but also for the spouse or bed partner. They too are disturbed by the noise and sleepless nights. 

• 20% of the population experiences snoring problems.
• Males and obese people have more problems with snoring.
• Snoring tends to be louder when a person sleeps on their back.

There are more than 350 devices registered in the U.S. Patent and Trademark Office to help cure snoring.

Q. How much sleep do I need?
A. The amount of sleep an individual requires varies from person to person, but most adults average eight hours of sleep.  Sleep plays a vital role in our daily regimen, as during this dormant period, it recharges and rejuvenates weary body organs and tissues, and restores the body to an alert state. Interruptions of sleep patterns will prevent this process. A person's lifestyle is another variable in the amount of time he needs to achieve this healthy balance, and to feel well rested upon awakening.

The quality of a person's sleep also factors into the sleep equation. When we drift off to sleep, we either fall into a deep, restful sleep, or into a shallow, light sleep. One who normally requires eight hours of sleep, but sleeps shallowly, will most likely awaken feeling tired. In contrast, if the same individual sleeps fewer hours, but lapses into a state of deep sleep, he may well awaken refreshed and invigorated.

Stop Snoring & Enjoy sleeping together again!