Snoring occurs when your soft palate vibrates as a result of two main factors: The muscle tone of the tongue and soft palate that tends to decrease during sleep. They both become more relaxed and may collapse and block the airways thus cause the snoring effect. The tonsils and tongue can produce sounds that may change the quality of the sleep. Your sleep position can affect the amount of snoring. Lying on the back makes the tongue fall back, block the airway and cause snoring. In addition, muscle tones tend to decrease with age, and that is why older people tend to snore more. Alcohol, some medications and physical exhaustion are also associated with snoring.
According to the National Sleep Foundation, snoring affects approximately 90 million American adults. Some people snore and do not suffer from interruptions of breathing and sleep that are the signs of sleep apnea. Some people who occasionally snore may develop heavy snoring, which might indicate sleep apnea. In adolescence, snoring can gradually become heavier, with longer sequences of no breathing, which can indicate sleep apnea. Elderly people who have never suffered from sleep apnea may lose muscle tone enough to trigger the development of sleep apnea.
What is sleep apnea?
According to the National Sleep Foundation, More than 18 million American adults have sleep apnea. According to Mayo Clinic, 12 million people in US suffer from Sleep Apnea, which causes them to breathing pauses during their sleep that increase the risk for high blood pressure, heart attack ,stroke and more. Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops. There are three kinds of sleep apnea: central sleep apnea (CSA), obstructive sleep apnea (OSA) and mixed apnea (CSA+OSA). Central sleep apnea is caused by central nervous system. The respiratory center in the brain, that controls breathing, stops sometimes working during sleep. The greatest difficulty of a person who suffers from central sleep apnea is sleeping and breathing at the same time. As soon as these patients fall asleep, they stop breathing and their emergency arousal response takes over, they wake up with a gasp. In severe central apnea the person may get very little sleep at all.
In obstructive sleep apnea the upper airway is blocked by the tissue of the soft palate, throat or tongue. A person who suffers from obstructive sleep apnea struggles to breath against the obstructed airway.
The third kind of sleep apnea is the mixed apnea, which is the most common type of sleep apnea. It is a combination of central and obstructive sleep apnea. Some researchers believe that most people who suffer from obstructive sleep apnea, have a central sleep apnea component and some abnormalities in the breathing reflex in the brain accompanies the development of obstructive sleep apnea.
What are the risks of sleep apnea?
In the 2005 Sleep in America poll, 8% of respondents experienced or had been observed having pauses in their breathing during sleep at least three nights per week. Adults in the poll were also given the Berlin questionnaire, a standardized test assessing risk for sleep apnea. Based on the questionnaire, 26% of all poll respondents were at risk. Of those at risk, 70% said that they snored, slept on average 6.4 hours/weeknight (compared to overall mean of 6.8 hours); 66% were experiencing daytime sleepiness at least 3 days per week and over half (58%) were obese. Of adults in this population who had been diagnosed with high blood pressure or depression, almost half were also at risk for sleep apnea. 33% of those who drink 4 or more caffeinated beverages daily are designated at risk for sleep apnea.
Sleep apnea can lead to serious health problems, but automobile accidents are one of the abrupt sources of injury. Automobile accidents are three times more common among people with untreated sleep apnea. Other health issues are the risks of strokes, heart attacks and even nocturnal sudden death. Low blood oxygen concentration during the night is responsible for much of the long term harm resulting from sleep apnea. In each apnea event, the blood oxygen drops to a low level, depriving the body’s cells of oxygen. It can affect the brain and explain the changes in personality, memory and alertness in people with sleep apnea.
Low blood oxygen concentration can cause high blood pressure. Chronic high blood pressure results in enlargement of the heart, which can cause stroke and heart failure. The relationship between high blood pressure and sleep apnea is not well understood, but it is known that in most cases, treating sleep apnea can improve the blood pressure.
Changes in blood pressure can also affect the operation of the lungs. Abnormal blood chemistry, caused by low oxygen and high carbon dioxide concentration in the blood, can also disturb the functioning of the lungs. Arrhythmia, which is an abnormal slowing of the heart, is also associated with sleep apnea. That is the reason that people with sleep apnea are at a higher risk of sudden death of heart failure during the night. The combined damage from abnormal blood pressure relationships in the heart and lungs, abnormal blood chemistry and arrhythmia is thought to be the greatest long term danger to health from sleep apnea.
Work performances, home and social life also suffer. People with sleep apnea suffer from poor concentration, memory loss and poor job performances. Studies show that married people with sleep apnea have the tendency to become socially isolated from their partners and children. The fatigue and sleepiness causes the sleep apnea sufferer to participate less and less in family activities and to spend more and more time withdrawn or sleeping. These problems may contribute to marital conflicts, child raising difficulties and divorce.
Symptoms of Sleep Apnea
Those who have OSA are often unaware of their condition and believe that they sleep well. The symptoms that usually cause these individuals to seek help are daytime drowsiness or complaints of snoring and breathing cessations observed by a bed partner. Other symptoms may include:
Snoring with pauses in breathing (apnea)
Excessive daytime drowsiness
Gasping or choking during sleep
Problem with mental function
Poor judgment/can't focus
Quick to anger
High blood pressure
Nighttime chest pain
Problem with excess weight
Large neck (>17" around in men, >16" around in women)
"If someone comes into my office and tells me that they suspect their partner has a sleep disorder, the first thing I do is ask him or her when they first noticed the partner's sleep symptoms. I like to know if the partner has shown symptoms for a long time or if the person is only noticing the issue now. Why? Because sometimes I find that people who realize their partner has a sleep disorder after years of living together could be dealing with sleep issues of his or her own.
Take for an example, a married couple with a husband who snores. If the wife goes through a bout of insomnia – she may suddenly take notice of the snoring because she can't sleep.
Usually, bed partners get into a comfortable routine – they may even get used to sleeping with a snoring partner.
Each partner has to take into consideration if there has been a change in the norm. If you’ve been together for years and all the sudden you have a problem – it may be treated differently from a new couple that has never been able to adjust to a sleep issue.
Out of respect, if the problem is causing your partner to sleep in another room or get injured (bed partners who kick or move a lot when sleeping) – you should see a sleep doctor. Snoring shouldn't be ignored – especially if it is loud with frequent pauses in breathing".
We need sleep in order to save the body’s energy, laying down memory, for physical growth and in order to restore daytime mental functions. In order to be in out best, each of us needs a certain quantity of sleep every night. If we do not get enough sleep, we develop a sleep “debt”. This leads us to feel sleepy during the day and to fall asleep more readily. There is no right or wrong answer to the question: how much sleep do we need? The amount of sleep a person needs is individual and it changes with age and circumstances.
The quantity of sleep we get is not the only thing that matters. Equally important is the quality of our sleep. A short nap is not as good as a deep and continuous sleep. The quality of our sleep is determined by a few sleep stages the brain passes through during the night. There are two kinds of sleep: REM (rapid eye movement) and non REM (NREM) sleep, which alternate with each other during the night. NREM sleep is also called the “quiet” sleep, in which the body is relaxed and your brain activity is normal. REM sleep is also called the “active” sleep, in which your breathing is irregular, the body temperature rises and the blood circulation to the brain increases. In addition, the large muscles in your body become paralyzed and your eye muscles become very active, which leads to rapid eye movements. Most of our dreams occur during REM sleep.
We all need REM sleep. People who do not get enough REM sleep seem to develop what is called REM rebound, in which the body tries to get as much REM sleep, in order to catch up on what was missed. People with sleep apnea are often deprived of the normal amount of REM sleep.
Which lifestyle changes can prevent snoring?
Snoring is an important medical condition that should and can be treated. In some cases, lifestyle changes can cure snoring problems: Loosing excess weight may help relieving constriction of the throat. Over weighted people usually have fatty deposits within their throat tissue, which narrow the upper airway. Second, in some heavy people the extra weight on the abdomen changes the way their stomach and chest muscles work, which alters the operation of their breathing reflexes. Alcohol and other medications can relax the muscles in the back of your throat and interfere with breathing. Avoiding those can help prevent snoring. Since sleeping on the back can cause the tongue and soft palate to block the airway, sleeping on the side or abdomen can also prevent snoring.
WHAT'S YOUR SNORE SCORE?
Your answers to this quiz will help you decide whether you may suffer from sleep apnea:
1.Are you a loud and/or regular snorer?
2.Have you ever been observed to gasp or stop breathing during sleep?
3.Do you feel tired or groggy upon awakening, or do you awaken with a headache?
4.Are you often tired or fatigued during the wake time hours?
5.Do you fall asleep sitting, reading, watching TV or driving?
6.Do you often have problems with memory or concentration?
If you have one or more of these symptoms you are at higher risk for having obstructive sleep apnea. If you are also overweight, have a large neck, and/or have high blood pressure the risk increases even further.
If you or someone close to you answers "yes" to any of the above questions, you should discuss your symptoms with your physician or a sleep specialist. Different treatment options exist; which is right for you depends upon the severity of your apnea and other aspects of the disorder. Talk to your doctor about choices. Untreated, obstructive sleep apnea can be extremely serious and cannot be ignored.