The whirr indicates the noise made by a person while sleeping. This noise which can reach 100 decibels is the result of a vibration of respiratory soft fabrics (known as naso-pharyngés: velum, bases pharyngées language and walls). Beyond 40 years, 60% of the men and 40% of the women whirr a little, episodically. But only 25% of the men and 15% of the women suffer from a pathological important whirr, called Ronchopathie. The whirrs are supported by tiredness, the catch of alcohol or certain drugs. The Obésité is also a factor of whirr or aggravation of that Ci. In addition to the anecdotic and banal aspect of this symptom, this one can mask another pathology much more serious, the apnea of the sleep. The consequences of these apnea and these whirrs cause many studies since the generalization of the recordings of the sleep, in hospitalization or maintaining in residence.

Details

During breathing, the air passes freely by the nose and the mouth, goes down in the pharynx, passes behind the base of the language to join the larynx, cartilage (Adam's apple) containing the vocal cords. The larynx is fixed in top of the trachea. It is the entry which carries out the air inside the lungs.

At the bottom of the mouth, behind of the language, free space is relatively narrow. The air must pass between the language, the velum, the luette and the wall of the pharynx. At the time of the sleep, the muscles are slackened, hypotonic. They then tend to subside what still reduces the passage. Individual anatomical conformations, and forms it jaw lower, condition the passage of the air. When the velum is long and thick, it reduces free space. These soft structures (pharyngée wall, velum, base language) join one against the other, and prevent the air from freely passing. It then occurs a vibration of the fabrics which results in the whirr. When this passage is reduced too much, the base of the language creates a phenomenon of valve. This blocking then prevents completely the air from penetrating in the lungs. The inspiratory efforts still accentuate this blocking, like a stopper placed at the entry of the trachea. It is the obstructive apnea.

Treatments

• Slimming: He will be always recommended in front of a ponderal overload. The reduction of the volume of the base of language and pharyngés fabrics will always improve the passage of the air.

• Surgery: Uvulo-Pharyngo-Plastie surgical operation (or UPP) is most current and consists in releasing the pharynx by dividing the edge of the velum and the luette. When they are obstructive, the amygdalae can also be removed. She is proposed for the whirr when the apnea are not very frequent (I.A. lower than 20/25) and do not involve functional embarrassment or of repercussion important. This act is painful but effective in particular when the operational indication is well posed, if the pharyngé contracting is important. The intervention practiced under general anesthesia involves a unavailability of about fifteen day because of pain and the difficulty food.

• surgery with the laser: Other techniques of treatment of the whirr were born these last years as the treatment by Laser which makes it possible to vaporize only the luette and it velum, leaving places amygdalae from there. This act which is carried out in several meetings under local anesthesia is also painful. It is less effective than the traditional surgery.

• The radio frequency: More recent still, the treatment by radio frequency consists in cauterizing and hardening the velum using a needle sending a beam localized of microwaves. Less aggressive but in spite of very painful, this treatment did not show a very great effectiveness yet, at least in the short or the long term.

• The Orthèse of advanced mandibulaire: It is about a double dental gutter which makes it possible to advance the jaw lower during the sleep. The language is thus separated of the posterior wall and releases the passage of the air. This system is effective but present problems of long-term tolerance, because of destabilization of the articulation temporo-mandibulaire. This prosthesis is proposed out of standard (approximately 90 euros in pharmacy). The first installation requires a heating in water in order to obtain a softening partial of the plastic to obtain a good adaptation to teeth. Other models are carried out to measure by the dentists or the stomatologists. They then are adapted perfectly, but their price (800 euros) is much higher. There is no catch of load by the social security for this type of prosthesis.

• The Flexible Nozzle Oropharyngée or C.S.O " Capax" It is about a simple system, derived from the nozzle of Guedel used in anesthesia, at the time it alarm clock, to prevent that the patient " do not swallow its langue". This prosthesis prevents the blocking of the passage of the air towards the larynx by the base of the language. It consists of a flexible silicone tube which is placed in the mouth. An external filter makes it possible to remove the air from dust and to humidify it. A rubber band holds the filter and maintenance the flexible tube in the mouth during the sleep. The air passes then freely to the larynx, without noise and blocking. This simple prosthesis is effective in the whirr and the apnea. Only the tolerance, related to the possible nauséeux reflexes, can pose problem. Largely used at the buzzers, this system is still in evaluation for the treatment of the apnea.

• To sleep on the side, or better, on the belly: the fact of sleeping on the back brings the language towards the back of the palate, thus reducing the clearance the passage of the air. To avoid it, one can place a small ball in the back of the pyjamas or get a tee-shirt antironflement. The change of position cannot make disappear a major whirr, but can erase a moderate whirr.

• Other solutions suggested: the spray oral or nasal containing oil or other products " naturels" especially a psychological effect and placebo have. Their broad diffusion rests especially on considerations marketing.

• The nasal strips or spacers narinaires improve only the entry of the air on the level of the nostrils but do not treat to in no case the whirr.

• The pillows anti-whirrs or any other system of maintenance in hyper extension can have a certain effectiveness by improving the passage of the air.

• The stimulative electric ones of wrists or other electronic devices which detect the whirrs contribute to the change of position in incentive to sleep on with dimensions one or the belly. There too one will erase a moderated whirr, in the condition as a preliminary, well of having regulated the intensity of the impulses of the apparatus not to awake the buzzer.