Snoring can signal medical condition
August 11, 2009 - 9:00 pm
The American Academy of Otolaryngology estimates that 45 percent of normal adults snore from time to time and as many as 25 percent are persistent snorers. According to the American Sleep Apnea Association, approximately two to four percent of adults, or an estimated 12 million Americans suffer from some form of sleep apnea. Although the two conditions may be related, they are not the same. It is possible to have one without the other. As Dr. David Brodner, of the American Academy of Otolaryngology stated, "If you snore it does not mean you have sleep apnea, but 99 percent of the people with sleep apnea snore."
Whether the noise comes from the person sharing your bed or the one sleeping in a room down the hall, snoring is easy to identify. The sound can be deafening. In fact, over two-thirds of the people responding to an on-line survey said their partner's snoring interrupted their sleep and they often awoke tired.
Snoring is caused by an obstruction to the free flow of air though the nose and throat. The most common reasons people snore are obesity, large tonsils or adenoids, or a deformity such as a deviated septum. Snoring also results from stuffy or blocked nose due to a cold or sinus problems.
Sleep apnea is a serious sleep disorder that is most common in middle-aged, overweight men. Greek for "without breath," apnea refers to what happens when a person stops breathing during sleep because the soft tissue in the back of the throat relaxes and closes off the airway. When the brain recognizes that there is no air, it rouses the sleeper briefly to take a breath. Apnea events can happen as many as 300 times a night and can last from 10 seconds to a minute each time.
"Sleep apnea is an underdiagnosed problem, especially among children," said Olya Banchik, DDS. "I can often tell by looking at children (that they're probably suffering from sleep apnea). Dark circles under the eyes, mouth breathing, and abnormal facial development can all be signs of sleep apnea in children."
Banchik said children with sleep apnea may not stop breathing, but the condition can still cause problems resulting from insufficient oxygen. Children with sleep apnea may start speaking later or have other speech problems.
Banchik said her own son snored loudly at 18 months. She didn't realize he had obstructive sleep apnea until he was 2 and a half years old. She took him to an ear, nose and throat specialist and found his airway was 90 percent obstructed.
Treating sleep apnea in children usually involves surgical removal of tonsils, adenoids or both, Banchik said. Overweight children with the condition sometimes improve with weight loss. Allergies may inflame and chronically enlarge the adenoids in children, and treating the allergies can bring improvement.
Banchik's son improved almost immediately after his adenoids removed.
Sleep apnea can be life threatening. When breathing stops, the body is deprived of oxygen and the results can be very serious. According to the American Thoracic Society, sleep apnea can in crease the risk of heart attack or death by 30 percent.
People who snore, or who unintentionally fall asleep during the day, are generally drowsy all day, suffer from insomnia, or wake from a sound sleep choking or gasping for air, need to be tested for apnea.
Other indications are severe headaches in the morning due to lack of oxygen during the night, depression, anxiety, increased irritability and short-term memory loss, Banchik said, adding that bedwetting can be a sign of the condition in children.
Whether one suffers from apnea or simply snores, it is important to find a solution. There are a number of excellent treatments on the market that can reduce the snoring and eliminate the apnea. For apnea, the most common is the continuous positive airway pressure machine, also known as CPAP, a mask that forces air at positive pressure into the airway during sleep. Although the machine works well for many patients, some can't tolerate sleeping in the mask. Other may require surgery to correct the problem.
Less invasive treatments are also available for both conditions. They vary from breathing strips for the nose that help hold the nasal passages open during sleep to chin bandages and chin pillows designed to keep the mouth closed so that a sleeper must breathe through the nose.
As with snoring, sleep apnea affects both the sleeper and the spouse. As Brodner said, "People who sleep in the same room with a partner with sleep apnea suffer from what is called 'spousal arousal syndrome.' They wake up when their partner doesn't breathe and they lose an hour and a half of sleep each night."
There are other options, particularly if snoring is the problem. Some homes now come equipped with a "snoring room." Chicago real-estate author and broker, Mark Nash, says that this new configuration is a trend that lets everyone get some deep sleep. The room is either attached to the Master Bedroom or just next door and is designed to provide the opportunity for intimacy and the privacy and quite everyone wants.
An increasing number of children, from age 11 to teens, are undergoing sleep apnea testing, Brodner said. He attributes the growing problem to the higher incidence of obesity in kids. Some of the young sufferers have significant sleep apnea, and many of them have been diagnosed with attention deficit hyperactivity disorder.
"A lot of the symptoms are the same as ADHD," Banchik noted, "increased inability to focus, irritability. Many have stunted growth and are at risk for hypertension. They may have ADHD, but they definitely have sleep apnea and that needs to be ruled out as one of the diagnoses."
Whether the problem is snoring or sleep apnea or both, the snorer should be examined by a doctor and take a sleep test. Pass or fail, doctors can help find the right solution for everyone.
FDA Approved Apnea and Snoring Treatments
Continuous positive airway pressure (CPAP) Machine
Description: A mask connected to an air blower is placed over the face and nose of the sleeper. The air gently flows through the nose. The rate of air pressure is variable to meet the needs of each sleeper.
The treatment is non-invasive but many find the device uncomfortable and noisy.
Surgery
Several surgical procedures are available to correct the problems that cause apnea and snoring.
Description: Procedures vary from removing tonsils and adenoids to implanting struts into the soft palate. Patients should talk with their doctor about procedures that best meet their needs
Invasive.
Life Style Changes
Losing weight, eliminating alcohol before bedtime, exercise that strengthens neck muscles are among the effective life style chances that treatment for sleep apnea and snoring.
Non-invasive. However, all these changes require a discipline that may be challenging for many patients.
"Strips"
Adhesive strips that aide in keeping airways open.
Description: Nose strips fit across the bridge of the nose to keep airways open. Chin strips are applied just below the mouth to keep the mouth closed during sleep and force the sleeper to breathe through the nose.
Non-invasive.
Dental Appliance
A small oral device that keeps the mouth closed during sleep.
Description: A one-piece appliance that fits in the mouth much like a retainer. It is fitted by a dentist and holds the tongue in place during sleep to keep it from dropping back into the airway and cutting off the air flow.
Non-invasive.
Chin pillows
A pillow that ties around the sleeper's neck to keep the lower jaw in place during sleep.
Description: A lightweight, round, very soft pillow that fits on the sleeper's neck and keeps the chin from dropping onto the chest. Adjustable Velcro fasteners hold the pillow in place.
Non-invasive.