Do you know someone who snores loudly?
Snoring can be attributed to many causes but is a symptom that should alert patients and those who love them to the possibility of sleep apnea. Sleep apnea is when a person stops breathing during sleep for a prolonged period of time. While it is unfortunately common, many people do not understand why it is important.
Sleep apnea has two major categories, central and obstructive. Today, I will address obstructive sleep apnea. The condition results when the tissues of the mouth and throat close off the airway (windpipe) while a person sleeps, thereby preventing him or her from breathing for a period of time.
The brain responds to this obstruction by gradually increasing the signal to the breathing muscles so they will contract harder to overcome the obstruction. Typically, the person snores loudly. This is a sign of incomplete obstruction, meaning that the airway is partially blocked but some air can move. The partial block results in vibration of the throat tissues, which causes snoring.
Not all snoring is a problem. It becomes a problem when it progresses to total airway blockage and the person stops breathing. Patients who snore should have a family member observe their sleep and breathing pattern. For people who stop breathing for a period of 10 or more seconds intermittently, sleep apnea is a concern.
When total airway obstruction occurs, the increasing muscle contraction eventually overcomes the obstruction and the airway opens. This may be accompanied by a loud deep inward breath followed by rapid breathing until the person settles back to sleep (and resumes snoring). These episodes, which often occur multiple times nightly, result in fitful sleep and excessive tiredness. Such people fall asleep frequently during the day and may have difficulty with concentration.
Of greater concern is the strain that sleep apnea puts on the heart and lungs. Low oxygen levels during these obstruction episodes increase pressure in the heart. The long-term consequences can include heart failure that can be life-threatening. Fortunately, sleep apnea can be treated.
Most commonly, obstructive sleep apnea results from being overweight (in which fatty tissues in the throat and chest bear down on the airway and collapse it). It can also be related to thyroid problems or enlarged tonsils and adenoids.
When sleep apnea is suspected, an evaluation usually includes an overnight sleep study. A sleep evaluation is usually performed by monitoring the patient’s breathing and oxygen levels during sleep in a sleep lab. Such evaluation not only can confirm the diagnosis but also can assist with fitting the patient with a device worn over the nose and mouth at night that helps to keep the airway open during sleep.
Ultimately, weight loss or treatment of other underlying problems is recommended.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.