Snoring and Sleep Apnea

Allen Blaivas, M.D. Health Pro
  • Do you snore? Do you have trouble sleeping because your spouse "rattles the walls" with their snoring? Are you are a little overweight and not fully refreshed by your sleep? Do you doze off a lot and just feel like you lack energy during the day? Then maybe the best holiday "gift" you can give yourself or significant other is an evaluation for sleep apnea.


    Ironically, we haven't really talked much about the most common sleep disorder - obstructive sleep apnea (OSA). There are some new and interesting developments, particularly regarding how OSA is diagnosed, that may be important information for some readers, so I wanted to begin talking about this topic.

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    First, let's cover the basics. There are two (technically three, but I will keep things simple for now) types of sleep apnea- obstructive and central sleep apnea. Obstructive is by the far the more common. Just to break down the words gives you an idea of what happens to the body. Apnea means "without breath", and sleep refers to the fact that it occurs only when sleeping. Obstructive means the apnea is caused by a blockage or obstruction in the airway that does not allow the sleeper to get air into the lungs through their airway. The only way to get oxygen into our blood stream is when the air we breathe can be transferred into the blood cells through the lungs. If oxygen-rich air does not reach the lungs, then obviously it can not reach the bloodstream.


    What causes this obstruction and what does it have to do with being tired during the day? The obstruction is generally caused when muscles and extra tissue (such as fat tissue) in the back of the throat collapses and blocks the airway. This occurs specifically during sleep, because it is at those times that the muscles relax and don't maintain their "normal" (i.e. awake) tone. In order for the sleeper to overcome this obstruction they increase their respiratory effort until they restore the muscle tone and reopen the airway. However, this extra effort frequently causes the brain to "wake up" (even though we might not be aware of it) and not maintain a normal state of relaxed sleep.


    Even though many hours are spent sleeping it is like having someone shake you to wake up 30, 40, 50, or more times EVERY HOUR. Doesn't sound very restful, does it? That's why people with sleep apnea are often sleepy during the day and why they sometimes complain that it feels that they haven't even slept, because they haven't really sleep well at all! This greatly increases their risk of drowsy driving - a danger to themselves and others - because people with sleep apnea tend to doze off behind the wheel from lack of effective sleep.


    The obstruction is commonly associated with loud snoring, because the tissue that obstructs the airway, at times, only partially blocks it. In people with OSA, bed partners report loud snoring interchanging with complete stopping of breathing- the apneas.


    What are some signs that you or spouse might be suffering from sleep apnea? OSA sufferers tend to be overweight, have large necks (17 inches in men and 16 inches in women), snore loudly, often have been told that they stop breathing during the night, and frequently wake up gasping for air.


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    Besides the very severe daytime tiredness that we already mentioned, sleep apnea can cause difficulty with memory or concentration, irritability, sexual dysfunction, or even depression. While many people think that sleep apnea can't kill you, that is far from the truth. Medical problems that have been connected to untreated OSA include high blood pressure, stroke, heart attack, congestive heart failure, more difficult to control diabetes, and irregular heart rhythms. And don't forget the car accidents mentioned above that can also kill.


    Now that I have got you thinking, if you have any of these signs or symptoms discuss them with your doctor and consider a referral to a sleep specialist. There will be lot more upcoming information on this topic, especially the new diagnostic method I referred to earlier, so stay tuned.


Published On: May 12, 2008