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When is Snoring Actually Sleep Apnea?
Mark Sheridan, M.D.
Tri-State Otolaryngology - Head and Neck Surgery
Q. My husband snores when he sleeps. In fact, he snores so loudly that he often wakes me up. Is there anything that can be done to help his snoring?
A. Snoring is the sound made when air passes through the nose and/or throat when a person sleeps. Sometimes, when we are overly tired, our bodies relax to such a degree that the air moving in and out of our nose and/or throat causes the tissues to vibrate. This makes the sound commonly referred to as snoring. It's a very normal process that affects almost all of us at one time or another. However, for a significant number of people snoring is a symptom of a much more worrisome problem called sleep apnea.
Apnea is the cessation of breathing for 10 or more seconds. Associated symptoms include hypersomnolence (the sensation of being tired all the time), malaise, fatigue, irritability and shortened sleep latency (the tendency to fall asleep as soon as your head hits the pillow). Sleep apnea can be associated with irregular heartbeats and high blood pressure.
Typically, persons with sleep apnea will awaken numerous times in the middle of the night, seemingly from the intensity of their snoring, but actually because they are strangling as they struggle to breathe. Most people with sleep apnea are overweight. Obesity and sleep apnea go hand in hand. Poor sleeping patterns associated with the apnea bring on lethargy and lack of exercise. The lack of physical activity in turn leads to obesity. It can become a self-defeating cycle.
There are two types of sleep apnea. The first type of apnea is caused by excess tissue in the nose and/or throat that collapses into the airway during sleep. This is called obstructive apnea and it is the most common type. The second type of apnea is central and is caused by a neurological problem where the brain doesn't tell the body to breathe. Fortunately, this second type is rare.
The diagnoses of sleep apnea are made by sleep studies. A sleep study records how many times someone stops breathing while he or she sleeps and also measures the amount of oxygen in the blood stream. This information is important in making the diagnosis.
Treatment may be medical or surgical. The most effective therapy is by CPAP (continuous positive airway pressure). This is a mask that fits over the nose while supplying a constant supply of air to the nose. The constant air pressure “stents” the airway open, allowing air to be inhaled with less effort. Surgical options include straightening the nasal septum in order to open the nasal passages, or removal of the tonsils and a portion of the soft palate and pharynx. This effectively removes the extra tissue and pulls open the airway. Some patients require both surgery and the CPAP machine. Weight loss also helps the treatment of this disorder.
Children may also be affected with sleep apnea but most often theirs results from enlarged tonsils and adenoids. Children are best treated with an adenotonsilectomy.
If you or someone you care about snores heavily and has any of the associated symptoms of daytime sleepiness, irritability or lethargy, you should be evaluated by a physician. Preferably, this physician should have special training in sleep disorders and their treatment. Typically, this would be an ENT physician or a pulmonologist.
Remember, while not all people who snore have obstructive sleep apnea, almost all those with apnea snore. For more information, please call (304) 522-6388.
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