“Laugh, and the world laughs with you; snore, and you sleep alone.”
– Anthony Burgess
The funniest comedians are those who point out the obvious. While Burgess’s quote brings a smile to us all, it is a very sad commentary on life in this 21st century. If you Google “snoring room,” you can see how this is becoming a desirable feature in upscale homes. Looking hard enough, you can find construction ideas on how to sound-proof your own snoring room.
Even if you do not realize you are snoring, your spouse, other family members, or your coworkers, are most likely very aware. They also suffer from your noisy snoring, or they see the signs of a tired body attempting to just get through the day. Recently, a condition known as “secondary snoring” has been shown to cost the bed partner of a snorer an average of 1.5 hours of sleep each night. Snoring, in fact, has also been shown to be a leading cause of divorce.
Snoring occurs when the airway becomes partially blocked or occluded. An example would be a tongue that falls back as we drift off into deeper sleep. As the air attempts to pass between the soft tissues lining this smaller passageway, the tissues vibrate, creating the snoring noise.
In many situations, this compromise is minor and the body continues to get adequate amounts of oxygen causing little or no harm. However, snoring is more than just an inconvenience for your bed-partner; it can be a major sign for Obstructive Sleep Apnea (OSA). The word “apnea” comes from Greek literally meaning “without breath.” In the Sleep Apnea patient, the soft tissues totally block the airway, cutting off the supply of oxygen.
In a given night, these apneic events (when a patient stops breathing) can occur anywhere from 30 – 50 times, and in some people as many as 60 – 100 times, per hour! An “Apneic Event” is defined as a time of at least 10 seconds that the patient stops breathing. In sleep studies, the average event is 20 seconds in duration with some as long as a minute or more! The Sleep Apneic awakes exhausted each morning because he has been fighting for oxygen all night long.
Here is a simple exercise to feel what a Sleep Apneic goes through each night; the only equipment you need is a watch with a second hand. Since an “event” is 10 seconds minimum, and the average event is of 20 second’s duration, we will split the difference and use 15 seconds. Remember, the Apneic exhales okay, but the collapsed airway keeps him from inhaling. Take a good, deep breath, and exhale completely. Do not inhale, but, rather, hold your breath as though you cannot inhale for 15 seconds. Now you know a little of what the apneic goes through each night – ALL NIGHT LONG.
Common side effects of sleep apnea patients are
Irritability
Impotence
Heart Attacks
Irregular Heart Beats
High Blood Pressure
Stroke
Gastroesophogeal Reflux Disease (GERD)
Heartburn
Dry Mouth
Morning Headache
Impaired Concentration
Decreased Libido
Depression
And, the obvious, Chronic Sleepiness
Thomas Dekker was correct when he said, “Sleep is the golden chain that ties health and our bodies together.”
Chronic Sleepiness can also cause learning or memory disabilities, as well as periods of nodding off while on the phone or at work. Obviously, sleep apnea patients are at a much greater risk of having auto accidents. And, who wants an airline pilot with sleep apnea?
The “Gold Standard” treatment for sleep apnea is CPAP – Continuous Positive Airway Pressure. The positive pressure in the airway keeps the tissues from collapsing, and allows the patient to breathe comfortably all night.
However, compliance is another issue. Many patients cannot wear the “head-gear” required for CPAP: they find it confining, and they feel claustrophobic. Even the patients diagnosed as “Severe Sleep Apneics” are only about 30% compliant – 70% put the CPAP machine in the back of the closet and never use it. Compliance for the mild to moderate sleep apneics is almost non-existent.
There is an alternative available for mild to moderate apneics. We can also use this alternative treatment for severe patients who will not wear their CPAP. These appliances have been shown to open airways better than opening the mouth wider (which is what apneics do at night) or even tipping the head back (like the head-tilt for CPR).
Here is a simple test to determine if you may have a sleep disorder:
• Have you been told that you snore?
• Have you been told that you stop breathing when I sleep, although you may have no recollection of this?
• Are you always sleepy during the day, even if you sleep throughout the night, and get 7 or more hours of sleep?
• Do you have high blood pressure?
• Have you been told that you sleep restlessly? Are you always tossing and turning while asleep?
• Do you frequently awaken with headaches in the morning
• Do you tend to fall asleep during inappropriate situations
• Have you and/or others noticed a recent change in your personality?
• Are you overweight?
• Is the diameter of your neck is at least 17 inches (15 for a woman). It is strictly neck size – it doesn’t matter if the neck diameter is due to muscle or fatty tissue.
Any one of these could indicate a sleep breathing disorder. The more yes answers you have, the more likely it is that a problem exists.
If you or a family member or a friend has any of these problems, or if you suspect a sleep breathing disorder, we are happy to discuss it and treatment options with you.
Dr. Hair is a member of the American Academy of Sleep Medicine as well as the American Academy of Dental Sleep Medicine.
