Snoring: how bad is it for you?

Do you snore when you sleep?

If you do, how many of the following do you experience?

  • Morning headache or chest pain
  • Excessive daytime sleepiness
  • Sudden awakenings with shortness of breath
  • Waking up with dry mouth or sore throat
  • Difficulty concentrating during the day
  • Experiencing mood changes, such as depression or irritability
  • Difficulty staying asleep
  • High blood pressure
  • Trouble getting up in the mornings
  • Problems with sex

If you have experienced some of the above signs or symptoms, you may have obstructive sleep apnea. Obstructive sleep apnea happens when the muscles in the back of your throat relax too much. Your airway then narrows or closes as you breathe in, decreasing the air flow into your lungs. This may lower the level of oxygen in your blood. Your brain senses this low oxygen level and wakes you up so that you can reopen your airway. This awakening is usually so brief that you do not remember it. People with obstructive sleep apnea may not know that their sleep was interrupted and may even think they slept well all night.

Risk factors

Anyone can develop obstructive sleep apnea. However, certain factors put you at increased risk, including:

  • Being overweight
  • Having a thick or large neck
  • Having enlarged tonsils or too much tissue at the back of the throat
  • Having a larger-than-average tongue
  • Having a deviated nasal septum
  • Being black
  • Being male
  • Being between 18 and 60 years old
  • Having diabetes or high blood pressure
  • Smoking or drinking alcohol

Complications

Obstructive sleep apnea can increase the risk of heart attack, abnormal heart rhythm, stroke, daytime fatigue and drowsiness, memory problems and eye problems like glaucoma.

Diagnosis

Your doctor can figure out if you have sleep apnea by taking your medical history, performing a physical examination and doing tests such as a sleep study. During a sleep study, you will wear monitors that track your heart rate, breathing and oxygen levels.

So what can you do if you have been diagnosed with obstructive sleep apnea?

Lifestyle changes

For milder cases of obstructive sleep apnea, your doctor may recommend lifestyle changes:
  • Lose weight if you are overweight
  • Exercise regularly
  • Cut down on or stop drinking alcohol
  • Stop smoking
  • Use a nasal decongestant
  • Avoid sleeping on your back

If these measures do not improve your sleep or if your apnea is moderate to severe, then your doctor may recommend other treatments.

Treatment

If you have obstructive sleep apnea, you may benefit from positive airway pressure. In this treatment, a machine delivers air pressure through a mask that fits into the nose or is placed over the nose and mouth while you sleep. Positive airway pressure improves sleep, reduces daytime sleepiness and improves quality of life.

The most common type is called continuous positive airway pressure, or CPAP. With this treatment, the air is supplied to your airway at slightly higher pressure, keeping it open. CPAP is the most consistently successful and most commonly used method of treating obstructive sleep apnea. The newer machines are smaller and less noisy than older machines.

Although some find the mask bulky, most people learn to adjust the mask to obtain a comfortable and secure fit. Several options are available, such as nasal masks, nasal pillows or face masks. Newer masks, such as a Philips DreamWear Minimal Contact Mask, are now available. Check with your doctor to see what adjustments you can make to the mask and the machine for improved comfort. You also may benefit from using a humidifier along with your CPAP system - it will lessen throat and nose irritation from dry air.

Bilevel positive airway pressure (BIPAP), another type of positive airway pressure, delivers preset pressure when you breathe in and a different pressure when you breathe out. This can make sleeping more comfortable.

Oral appliances are an alternative for some people with mild or moderate obstructive sleep apnea. Some devices keep your airway open by bringing the jaw forward. Other devices hold the tongue in a different position. These devices may relieve symptoms and improve sleep. Surgery is sometimes needed for obstructive sleep apnea. The goal is to prevent blockage of the upper airway during sleep.

Surgery is usually considered only if other therapies have not worked or were not possible to perform.

Lifestyle changes and over-the-counter therapies

  • Lose weight. Even a slight loss of extra weight may help relieve the narrowing of your airway.
  • Exercise. Aerobic exercise and strength training could help improve sleep apnea. Try to exercise at 2-3 hours per week, and 3-4 days per week.
  • Avoid alcohol, sedatives and sleeping pills. They can worsen obstructive sleep apnea and sleepiness.
  • Sleep on your side or belly. Sleeping on your back can cause your tongue and soft palate to rest against the back of your throat, blocking your airway. To prevent sleeping on your back, try sewing a tennis ball in the back of your pajama top.
  • Use a saline nasal spray to help keep your nasal passages open, if you have congestion. Talk to your doctor about using nasal decongestants or antihistamines, because some medications may only be recommended for short-term use.

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