For some, small soft palate implant reduces snoring



Minneapolis Star Tribune

It would be an exaggeration to say that Patrick DeNucci's snoring endangered his marriage. But quieting his nightly rumble has saved him "a few elbows to the head."

"It's not eliminated," said DeNucci, 61, who has been married for 28 years. "But Judy would tell you it's much better."

DeNucci's doctor, Philip Rapport, thinks life -- and sleep -- could also get better for more of the estimated 90 million snoring American adults now that the U.S. Food and Drug Administration has approved more extensive use of Medtronic's Pillar Palatal Implant System. The procedure, in which thin polyester implants less than an inch long are inserted into a patient's soft palate, stiffens the palate tissue and lessens the vibrations that result in snoring.

Doctors now can insert up to five Pillar implants into the soft palate to treat snoring. They had been limited to three. Rapport said this will allow patients with wider or thicker palates to potentially see better results.

"We have found that, for about two-thirds of patients, snoring intensity was reduced by 50 percent. And about 80 percent of bed partners reported satisfaction," Rapport said. "But there were people who were not satisfied."

The Pillar implants are just one of many snoring remedies, from mouth guards to laser surgery, designed to give people desperately needed relief from the chainsaws in their heads. About 45,000 people worldwide have had the Pillar devices implanted, which takes about 20 minutes and requires only a local anesthetic.

The doctor inserts the devices using a tool that looks a little like a toy gun with a long sterile metal tip at the end.

The Pillar device was approved by the FDA in 2004. Limiting the Pillar's potential popularity, Rapport acknowledged, is that most insurance companies will not pay for it. It can cost $1,500 to $2,100, depending on how many of the implants are used.

Pillar palatal implants also are used to treat mild to moderate sleep apnea, although the FDA has approved only the implantation of up to three devices to treat that condition. The doctor said he would like to see a study looking at the impact of implanting up to five devices.

"Once the information became available that four was better or that five was better, we started talking to patients," Rapport said. "What we really are hearing is that this is resulting in improved sleep."

Both for the patient and the person who shares a bed with them.

"The real key is when the bed partner notices," Rapport said. "I had one spouse tell me 'This isn't working.' Then, a couple nights later, say: 'Oh my gosh, he's silent.' "

However, a search regarding the procedure in a handful of online forums found that while several people said the device improved their snoring, some said that it did not. Some said they still needed to use other remedies in addition to Pillar to get a good night's sleep.

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