What is sleep apnea?
A struggle for air; unusually loud snoring often accompanied by kicking, flailing and body spasms; feeling disoriented upon awakening and drowsy the rest of the day—those are the symptoms of sleep apnea, a disorder in which people literally stop breathing as they sleep. It happens when muscles in the throat wall relax so much that they actually close up in the deepest stages of sleep, blocking the flow of air. After 20 seconds or so of not breathing, the person is awakened to a lighter level of sleep, only to be disrupted again as he or she heads toward deeper sleep once more. The consequence? It becomes difficult, if not impossible, to get a good night’s sleep. Since obesity is a common culprit in sleep apnea, losing weight is one of the best ways to find relief. A special machine that helps sufferers breathe may also ease the problem.
Self-help for snorers
- Exercise regularly to develop good muscle tone.
- Maintain a healthy weight.
- Avoid alcohol within four hours of bedtime.
- Avoid tranquilizers, sleeping pills and antihistamines before bedtime.
- Sleep on your side rather than your back. Sew a “snore sock” (a sock with a tennis ball in it) to the back of your pajamas. It will prevent you from rolling onto your back during sleep.
- Raise the head of your bed (not your pillow) four inches.
- Wear a whiplash collar to bed to keep your chin extended.
The scoop on snoring
The loudest snore recorded was 90 decibels, which is louder than the engine sounds when you’re riding in the back of a bus.
Most animals don’t snore because they don’t sleep on their backs. Bulldogs and other breeds with short heads are a notable exception. Occasionally, these dogs require surgery to keep them from strangling while asleep.
Snoring can seem funny. Remember the last time Uncle Bill snorted and gasped his way through your annual Super Bowl party? But for people who are awakened night after night because they can’t breathe, snoring is no laughing matter. Instead it’s a chronic problem, one that may require medical treatment.
In most cases, snoring is caused by flabby muscles in the airway. In deep sleep, these muscles do a poor job of holding the tongue in its proper position. The tongue falls into the airway and vibrates against the soft palate (the back of the roof of the mouth), uvula (the little “knob” that hangs down from the soft palate) and the sides of the throat. Snoring is more pronounced in people who have large tonsils and a long, soft palate and uvula.
Other factors associated with snoring include an underactive thyroid gland; a receding chin; being overweight; obstructed nasal breathing (which might occur with a cold or an allergy episode); and the use of alcoholic beverages, tranquilizers and antihistamines.
While mild snoring may be no more than a nuisance, heavy snorers are more likely to have high blood pressure and to suffer strokes and chest pain than nonsnorers. Snoring can also be downright embarrassing, and more than one marriage has suffered because of it.
When snoring disrupts your life or interferes with a good, restful sleep, a visit to the doctor is in order. What can you expect? When seeking treatment from an ear, nose and throat specialist, a pulmonologist or another physician, your doctor will do a complete examination of the upper airway.
If you experience frequent snorting or choking while asleep, you may be asked to spend a night in a sleep lab to find out if your snoring is symptomatic of sleep apnea. Sleep apnea is a serious condition in which breathing stops completely for 10 seconds or more seven to 10 times per hour. (See “What Is Sleep Apnea?”)
Medical treatment of benign snoring or apnea may include a prescription for a nonsedating, tricyclic antidepressant. This drug decreases the amount of time the sleeper spends in a rapid eye movement (REM) sleep, when snoring and apnea are worst.
In more severe cases, a patient may be required to wear a nasal mask to bed. The mask keeps the airway from collapsing during sleep. Oral appliances that keep the tongue from dropping into the airway also can help some heavy snorers.
For some patients, a physician might recommend surgery to remove a portion of the uvula and soft palate. This procedure is called an uvulopalatopharyngoplasty (UPPP), and it requires a brief hospital stay. A laser is often used in this surgery. Partial UPPP surgery may be performed in a physician’s office, rather than the hospital.