When is snoring just annoying, and when is it a sign of something worse?
Millions of adults snore. Although some find that it isn't an issue in their lives, others report that snoring can be a serious annoyance to family members. For some, it can be so serious that it causes bed partners to sleep separately, leading to marital discord in some couples.
People often snore more when they've gained a few pounds, when they've had alcohol or even sleeping in specific positions. Effective treatments exist for snoring, such as using nasal strips, losing weight, steering clear of alcohol and sedative medications at night, and avoiding sleeping on one’s back. For many, though, these are simply not enough, and snoring is a sign of a more serious sleep disorder: obstructive sleep apnea (OSA).
When we fall asleep, the muscles in our body relax, including the muscles in our throat and airway. Some people have a narrow throat area and when the muscles relax during sleep, the airway can become blocked or further narrowed which leads to pauses in breathing (often longer than 10 seconds at a time!). A pause in breathing is called an apnea and a decrease in airflow during breathing is called a hypopnea. Almost everyone has brief apneas while they sleep, but having multiple apneas and/or hypopneas every hour is cause for concern. The snoring in people with obstructive sleep apnea is caused by the air trying to squeeze through the narrowed or blocked airway
OSA is reported to affect 3 percent of all women and 5 percent of all men, but these estimates are outdated; the numbers are likely much higher for both women and men given the increasing obesity rates in our society. Although being overweight increases your risk of developing OSA, you don't have to be overweight to have OSA. The most common risk factors for OSA include: male gender, over age 40, having a large neck size (17 inches or more for men and 16 inches or more for women), gastroesophageal reflux, nasal obstruction due to allergies, deviated septum or sinus problems.
Many doctors don't routinely ask about snoring, so it is important to bring this up to your doctor if you have any concerns.
The best three signs of OSA include the three S's: loud snoring, excessive daytime sleepiness, and stops/pauses in breathing observed by someone else. Other symptoms may include: difficulty staying asleep, using the bathroom multiple times per night, waking with a dry mouth, headache or heartburn, and having hard-to-control blood pressure. Talk with your doctor if you have the three "S's" or if you have a combination of any of the above symptoms.
If left untreated, OSA can lead to a number of poor medical outcomes. These include: high blood pressure, heart failure, irregular heart rhythms, stroke, heart attack, diabetes and weight gain. Untreated OSA can lead to excessive daytime sleepiness and problems with attention, concentration and motor functioning. OSA can cause poor work and school performance and can put one at greater risk for motor vehicle crashes. In addition, having OSA can make it harder to do many things one normally enjoys simply because of the increased sleepiness. As a result, many believe that OSA can lead to, or worsen, depression in those who have sleep-related breathing issues. OSA has also been linked to worsening of ADHD.
To properly be diagnosed with OSA, you need to go to a sleep center and be evaluated by a sleep specialist. You’ll likely need a sleep study (either sleeping overnight in a lab or sleeping at home with a special cap on your head) to diagnose OSA. Your doctor will then discuss diagnosis and treatment options.
Treatment options for sleep apnea fall into three categories: behavioral, medical and surgical.
Behavioral changes include losing weight (as little as a 10 percent reduction in your weight can significantly decrease OSA severity), sleeping in a different position (usually on the side and avoiding the back) and avoiding alcohol and sedatives at night.
Medical intervention is typically a continuous positive airway pressure machine (CPAP). This is considered to be the “gold standard” and most effective of all OSA treatments. CPAP consists of a small machine that is put bedside. Attached to the CPAP machine is a hose and mask. The patient wears the mask whenever asleep. CPAP gently blows air through the house and acts to keep the airway open when you fall asleep and muscles relax. Although CPAP isn’t generally thought of as very “attractive” or “romantic” to have when sleeping next to your partner, it can save your life and greatly improve your quality of life. Patients are encouraged to discuss these concerns with their doctor and trouble-shoot to make CPAP a regular part of their sleep.
Surgical treatments typically involve removal of the tonsils and adenoids as well as any surrounding tissue that might lead to a narrowing of the airway. Newer surgical procedures are being introduced as well, but currently, CPAP treatment has much better effectiveness rates in comparison to surgery.
Successful treatment of OSA can help increase energy levels, reduce the risk of heart attack, stroke, diabetes and high blood pressure. In addition, getting proper treatment for OSA can help you lose weight faster (more energy equals: more ability to burn calories!) and may also reduce symptoms of depression. That should be enough for you to check out your snoring with a doctor, if it's starting to disrupt your day-to-day!
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