***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: STUDY OBJECTIVES To evaluate pain , swallowing , speech , edematous response , tissue shrinkage , sleep , snoring , and safety ( energy limits and adverse effects ) following radiofrequency ( RF ) treatment to the palate in 22 subjects with sleep-disordered breathing . DESIGN This investigation is a prospect i ve nonr and omized study . Polysomnography , radiographic imaging , and infrared thermography , along with question naires and visual analog scales , were used to evaluate the effects of RF treatment to the palate . SETTING Treatments were delivered on an outpatient basis at Stanford University Medical Center . PATIENTS Twenty-two healthy patients ( 18 men ) , with a mean age of 45.3+/-9.1 years , were enrolled . All were snorers seeking treatment and met predetermined criteria : a respiratory disturbance index < or = 15 , oxygen saturation > or = 85 % , and a complaint of daytime sleepiness . INTERVENTION RF was delivered to the submucosa of the palate with a custom-fabricated electrode for a mean duration of 141+/-30 s with a mean of 3.6+/-1.2 treatments per patient . Reduction of their snoring scores determined the end point of the study . RESULTS Neither speech nor swallowing was adversely affected . Pain was of short duration ( 0 to 48 h ) and was controlled with acetaminophen . There were no infections . Although there was documented edema at 24 to 48 h , there were no clinical airway compromises . Polysomnographic data showed improvement in esophageal pressure measurements of the mean nadir and the 95th percentile nadir ( p=0.031 , p=0.001 ) respectively , as well as the mean sleep efficiency index ( p=0.002 ) . Radiographic imaging showed a mean shrinkage of 5.5+/-3.7 mm ( p < or = 0.0001 ) . Subjective snoring scores fell by a mean of 77 % ( 8.3+/-1.8 to 1.9+/-1.7 , p=0.0001 ) accompanied by improved mean Epworth sleepiness scores ( 8.5+/-4.4 to 5.2+/-3.3 , p=0.0001 ) . CONCLUSION The results of this investigation allowed the formulation of safety parameters for RF in this defined population with mild sleep-disordered breathing . There was a documented tissue reduction and improvement in symptoms in all subjects . However , given the small sample size and short-term follow-up , these results should be confirmed by further investigation Conventional uvulopalatopharyngoplasty has in the last years to an increasing extent been succeeded by a variety of laser procedures for snorers obstructed by lax palates only . These surgical techniques have the advantages of being less traumatic and therefore more suitable for local anesthesia and outpatient surgery . However , to the authors ' knowledge , there are no studies on degree of patient discomfort during this type of surgery as well as the value of anticholinergic component in premedication in preventing bradycardia and hypersalivation during the operation . We studied 53 consecutive patients undergoing laser-uvulopalatoplasty ( LUPP ) under local anesthesia at our day care unit .  LUPP is a one-stage operation for rhonchopathy which has been developed at our department . Twenty-five patients received morphine and scopolamine , and 28 morphine alone as premedication . Peroperative salivation , bradycardia and nausea was estimated and recorded for each group . Later the patients were asked to assess mouth dryness both before and after surgery , as well as satisfaction with sedation and pain relief . The great majority of the patients ( > 80 % ) described only insignificant pain , which when occurring was related to subliminal premedication or to the injection of local anesthesia or both . Morphine-scopolamine was significantly better in preventing hypersalivation ( p < 0.01 ) during surgery and also improved sedation and analgesia when compared to morphine alone ( p < 0.05 ) . The efficacy of LUPP is compared with various laser procedures for snoring OBJECTIVES We examined the early effects of radiofrequency thermal ablation performed to the soft palate on snoring level , apnea index ( AI ) , and daytime sleepiness of patients with simple snoring or mild obstructive sleep apnea ( OSA ) . PATIENTS AND METHODS The study included 88 patients having a diagnosis of simple snoring without apnea ( n=61 ) , apnea with AI < or = 5 ( n=13 ) , and mild OSA with 5 < or = AI < or = 15 ( n=14 ) .  Radiosurgery was performed to three or four locations on the soft palate and uvula under local anesthesia , with some patients requiring a subsequent procedure . The results were evaluated two months after the final session using the Epworth Sleepiness Scale ( ESS ) and visual analog scale ( VAS ) . RESULTS The complaints completely disappeared in three patients ( 3.4 % ) . Improvement was more than 50 % in 79 patients ( 89.7 % ) and less than 50 % in two patients ( 2.2 % ) . There was no change in four patients . The mean snoring symptom level , snoring noise level , ESS score , and apnea index were 3.01+/-1.96 , 1.43+/-0.79 , 3.55+/-2.58 , and 3.20+/-1.85 , respectively . The results were significantly improved compared to pretreatment values in all the patient groups ( p<0.001 ) . CONCLUSION Radiofrequency thermal ablation is an effective and well tolerable treatment method for simple  snoring  ,  mild OSA  , and associated daytime sleepiness , with minimal postoperative morbidity and a low complication rate Even in the absence of sleep apnoea , heavy snoring may be a cause of excessive daytime sleepiness ( EDS ) and fatigue . The aim of this investigation was to study whether uvulopalatopharyngoplasty ( UPPP ) is effective in relieving snoring and excessive daytime sleepiness in nonapnoeic snoring patients .  UPPP was assessed in 155 nonapnoeic , snoring patients ( 136 men and 19 women , mean age 45 yrs ) . Postoperative evaluation was made after 3 months in 105 patients , and after 12 months in 50 patients . Fifty four patients were evaluated after both 3 and 12 months . In 49 patients , a further evaluation was made after 2 yrs . The results were compared with those of 76 conservatively-treated , nonapnoeic , snoring patients , who were reinvestigated 12 months after their initial examination . The proportion of patients with frequent loud snoring had decreased postoperatively from 96 to 18 % . A highly significant improvement was reported in EDS and daytime fatigue . The proportion of patients who reported problems staying awake when driving had decreased from 29 to 7 % , and the number who felt rested when awakening in the morning had increased from 23 to 78 after the operation . The patients in the UPPP group had somewhat more severe symptoms before treatment than those treated conservatively . One year after treatment the situation had been reversed , with significantly more snoring and excessive daytime sleepiness in the conservatively-treated group . In conclusion , these results indicate that UPPP is effective in relieving snoring and EDS in nonapnoeic snorers The study objectives were to describe the changes in signs and symptoms of  obstructive sleep apnea ( OSA ) and snoring using a m and ibular protruding device ( MPD ) and to define the group of responders . The design of the study was a nonr and omized , open-labeled , prospect i ve clinical study with a duration of 6 months . The setting was a hospital sleep laboratory and an ear , nose , and throat and dental outpatient clinic . Patients included 35 individuals treated : 22 with a diagnosis of OSA and 13 who snored without apnea . The intervention before MPD prescription entailed a medical examination , a one-night somnographic registration , a question naire , and a clinical jaw function examination . All procedures were iterated at the 6-month follow-up . When the patients used the MPD , the subjective symptoms decreased significantly ( p < 0.001 ) . Twenty-four of the 35 patients were classified as responders , i.e. , reduced their symptoms ≥50 % . In the groups of OSA patients , the mean peak intensity of the snoring sound decreased from 71.6 dB to 62.0 dB ( p < 0.001 ) and in the group of snorers , from 63.5 dB to 57.5 dB ( p < 0.05 ) . Eighteen of the 22 OSA patients decreased their ODI values by ≥50 % ( responders ) . The mean ODI decreased from 15.4 to 3.5 ( p < 0.001 ) and the blood oxygen saturation , SaO2 nadir , increased from mean 81.9 to 85.7 ( n.s . ) . Most patients with tongue base hyperplasia were classified as responders to the MPD treatment . In conclusion , a 6-month perspective shows that the MPD could be an effective treatment in reducing signs and symptoms of OSA and /or snoring , the compliance was acceptable and only minor adverse events occurred Laser-assisted uvulopalatoplasty ( LAUP ) is a procedure for the treatment of snoring and , possibly , sleep apnea . Between July 1993 and December 1994 , the authors prospect ively evaluated 541 consecutive patients referred to their teaching hospital for possible LAUP to treat loud , disruptive snoring . Of these patients , 274 ( 51 % ) had one or more LAUP treatments .  As of January 1995 , LAUP treatment courses were completed in 170 patients . In this paper , the authors report preliminary results on the use of LAUP in these patients . Among the 170 patients , 105 ( 62 % ) had a diagnosis of snoring and 65 ( 38 % ) obstructive sleep apnea syndrome ( OSAS ) based on preoperative polysomnography .  LAUP treatment in the snoring only patients result ed in complete or nearly complete elimination of snoring in 63 patients ( 60 % ) , partial improvement of snoring in 30 patients ( 29 % ) , and no improvement in 11 patients ( 10 % ) . Of the 65 OSAS patients treated with LAUP , postoperative polysomnograms were obtained in 33 patients ( 51 % ) . Surgical success was achieved in 16 ( 48 % ) of the 33 patients . However , 7 patients ( 21 % ) had repeat polysomnograms that were worse than their preoperative polysomnograms , and 5 patients ( 15 % ) had no significant change . The results of this study suggest that LAUP may be a viable surgical option for patients with snoring and mild sleep apnea OBJECTIVES This study aim ed to evaluate differences in post-operative pain comparing KTP laser-assisted uvulopalatoplasty without tonsillectomy ( LAUP ) with a new described surgical method : coblation uvulopalatoplasty with tonsillectomy ( CP ) . We also evaluate the impact of each surgical technique in reduction of snoring loudness . MATERIAL AND METHODS Single blind r and omized-controlled trial . From a population of 41 consecutive patients on the waiting list for uvulopalatoplasty for simple snoring , the study group was reduced to 17 CP and 13 LAUP .  Post-operative pain and reduction of snoring loudness were recorded using visual analogue scales ( VAS ) during the first 15 post-operative days . Post-operative snoring loudness was documented for 1-year period . RESULTS Both groups had similar post-operative pain during the first seven post-operative days . A statistically significant reduction in post-operative pain was observed in the CP group after day 8 , and maintained until the end of the study . Reduction of snoring loudness was significant in both groups , but no differences were observed between them . DISCUSSION Coblation uvulopalatoplasty compared with LAUP demonstrates a reduction in post-operative pain , significant after the first post-operative week . The collateral thermal injury caused by laser is responsible for the slow-healing rate and maintained post-operative pain . Coblation dissociates tissue at lower temperatures with minimal collateral thermal injury and consequently faster and less painful recovery . Both surgical procedures have significant and similar reduction in snoring loudness . CONCLUSIONS Both methods are adequate treatment options for snoring .  The less painful recovery in CP promotes this surgical technique as our preferred choice for palate surgery CONTEXT Excess body weight is positively associated with sleep-disordered breathing ( SDB ) , a prevalent condition in the US general population . No large study has been conducted of the longitudinal association between SDB and change in weight . OBJECTIVE To measure the independent longitudinal association between weight change and change in SDB severity . DESIGN Population -based , prospect i ve cohort study conducted from July 1989 to January 2000 . SETTING AND PARTICIPANTS Six hundred ninety r and omly selected employed Wisconsin residents ( mean age at baseline , 46 years ; 56 % male ) who were evaluated twice at 4-year intervals for SDB . MAIN OUTCOME MEASURES Percentage change in the apnea-hypopnea index ( AHI ; apnea events + hypopnea events per hour of sleep ) and odds of developing moderate-to-severe SDB ( defined by an AHI > or = 15 events per hour of sleep ) , with respect to change in weight . RESULTS Relative to stable weight , a 10 % weight gain predicted an approximate 32 % ( 95 % confidence interval [ CI ] , 20%-45 % ) increase in the AHI . A  
    Output:
    
Both UP3 and LAUP reduced the number of snores per hour and produced a modest reduction in snoring loudness .
UP3 was effective in reducing a number of subjectively reported snoring indices , but results on objective measures were equivocal .
Limited evidence indicates that subjectively assessed snoring is improved after LAUP ; no objective measures were assessed .
RFA was associated with a reduction in partner-assessed snoring intensity , though evidence for an objective reduction in snoring sound levels was mixed .
Pillar implants were moderately effective at reducing partner-rated snoring intensity , but had no effect on objective snoring indices .
Use of CPAP reduced the number of snores per hour ; no subjective measures were evaluated .
This study highlighted the paucity and poor quality of the evidence available on the effects of both surgical procedures and non-surgical devices for the management of primary snoring .
There was no procedure that was clearly the least-cost option .