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Snoring and Sleep Apnea

Snoring is a very common condition which affects the majority of the population, whether directly or indirectly. No matter whether you snore, or your partner does, it disturbs the sleep for both of you. Snoring can become such a huge problem that many couples decide to have separate bedrooms. However, for many people, snoring can be a symptom of sleep apnea. During a sleep apnea episode, the breathing stops, which can happen to hundreds of times during sleep. This can trigger a number of serious health risks and issues and thus, it should be taken seriously. Let’s take a closer look at the connection between snoring and sleep apnea.                    

What is Social Snoring? 

Social snoring is the name given to the instances when a person snores or is disturbed at night time by a partner who snores. It is a twice as common issue for men than for women. It has been estimated that the noise of the snoring increases with age and that the highest prevalence of snoring occurs in the age range 50 to 60 years old. Moreover, people who are overweight tend to snore more and people who have more central excess fat distribution around the middle and neck are more prone to snoring. 

Snoring During Pregnancy

Many women snore when pregnant, especially in the final phases. It has been estimated that over 20% of all pregnant women snore. However, various studies have shown that pregnant women who snore are twice at the risk of high blood pressure and pre-eclampsia.

Sleep Apnea

Sleep apnea is a common condition associated with snoring. It is characteristic with a repeated breathing suspension during sleep. This is a serious sleep disorder which is linked with a number of health conditions, including heart and artery problems, hypertension, depression, and diabetes. People who have sleep apnea are more susceptible to traffic accidents due to excessive daytime sleepiness. The sleep apnea episodes last at least 10 seconds and a person with a severe form of sleep apnea can experience 600 such episodes per night. 

Sleep apnea affects a lot of people all over the world, but 85% of cases are undiagnosed and consequently, untreated. This condition is more prevalent in people with high blood pressure, who are older and overweight. 

Sleep Apnea in Children

Sleep apnea is a condition which causes air pathway obstruction and it can also happen to children. Children shouldn’t snore and thus, sleep apnea in children is often associated with enlarged tonsils or adenoids which can block the upper air pathways.

Types of Sleep Apnea

There are three types of sleep apnea including, central sleep apnea, obstructive sleep apnea, and complex sleep apnea. 

Central sleep apnea doesn’t usually cause snoring and it’s usually a result of a complete or partial reduction of the nerve impulses to the breathing muscles. During the apnea episodes when the breathing interruptions happen, the breathing movements first increase and then successively reduce to a central apnea completely without chest movements. These episodes last at least ten seconds during which the body makes no attempt to inhale air. What the reasons, the consequences and the possible treatment for central sleep apnea are, it is still a mystery. 

Obstructive sleep apnea is characteristic with a narrowed upper air pathway, which triggers daytime tiredness. During the breathing pauses, the breathing movements are vigorous but the upper air pathway is blocked and the person doesn’t get air. The reasons are usually enlarged tonsils, enlarged adenoids, or the tongue which has fallen backwards. Additionally, obstructive sleep apnea can occur when a person is overweight and has excessive fat around the neck. 

Complex sleep apnea, also known as mixed sleep apnea, is a mix of the two previously mentioned types. It happens when people with obstructive sleep apnea start using CPAP and develop symptoms of central sleep apnea. During the CPAP therapy, the patients with obstructive sleep apnea get relief on the obstructed airways, but continue having difficulty breathing while asleep. Hence, it indicates that their obstructive sleep apnea symptoms shift to central sleep apnea symptoms. 

Symptoms of Sleep Apnea

Many people are unaware that they snore or that they have sleep apnea, especially if they live alone. Hence, many people live many years with these conditions and they often find about them unexpectedly. Some of the most common symptoms of sleep apnea include excessive daytime tiredness, snoring, disturbed sleep, dry mouth, morning pain in the pharynx, constant need to urinate during sleep, waking during sleep with a feeling of suffocation, mood swings, high blood pressure, giddiness, acidic indigestion, a feeling of never being rested, and morning headache. 

Underlying Reasons for Snoring

Breathing might be a natural process, but a complex procedure. It is controlled by signals from the breathing center in the lower part of the brain stem. It can be either controlled voluntarily or by various reflexes. The muscles in the walls of the pharynx react and widen reflexively when we are awake and inhaling. However, when we are asleep, the muscles relax and the walls of the pharynx become more or less slack and more sensitive to changes in pressure. Some people experience a slight muscle activity and thus, cannot hold the airway open during inhalation. The low pressure, which is formed when inhaling, can make the walls of the pharynx to be pressed inwards until they collapse together completely. So, in a combination with reduced muscle tension in the soft palate and the tongue which falls backwards, the enlarged tonsils and adenoids in the nose and the fatty deposits in the upper airways can result in constricted upper air pathways, and consequently snoring.

The noise we hear while snoring is a result of the vibrations which occur when the air pathway in the pharynx is too narrow and the soft palate begins to vibrate. In some of these cases, the upper pathway becomes completely blocked during inhalation which triggers a sleep apnea. 

There are a number of reasons why a person snores or has sleep apnea, including poor dietary choices, using muscle relaxant drugs, alcohol habits, poor health, slack musculature in the pharynx and air pathways, being overweight, genetics, some health conditions such as hypothyroidism, stroke, diabetes, hypertension, or rheumatism, and passive smoking. 

Diagnosing Sleep Apnea

If you notice that you have some of the above-mentioned symptoms and suspect that you have sleep apnea, it is probably best to visit your general practitioner. They are likely to refer you to a specialist clinic for sleep investigation. Then, you are likely to undergo a sleep study which will determine whether or not you have sleep apnea. 

Sleep Apnea Treatments 

There are a number of possible treatments for snoring and sleep apnea. In order to choose the correct treatment, several factors will be taken into account, such as your age, the severity of your apnea, and other health conditions and circulation problems you might have. 

The most common and effective treatment for sleep apnea is continuous positive airway pressure therapy, also known as CPAP. This is a device which creates high-pressure which compensates for the reduced breathing ability. It is a device which should be used every night. 

CPAP features a high-pressure breathing mask which is most effective for medium and severe cases of sleep apnea. The patient is required to wear the mask during sleep which will open the pathways. Wearing the CPAP mask can be bothersome, but it helps if you pick a mask which fits perfectly. 

Besides CPAP, there are also oral appliances for sleep apnea, which are beneficial for people who have slight to medium sleep apnea. Thus, oral appliances are a common treatment alternative to CPAP in patients who cannot tolerate other treatment options. The oral appliances are usually tested by a dentist and they work by pushing the lower jaw forward and thus, make breathing easier during sleep. These devices are put in the mouth and it can move teeth to some extent, which is not something everyone would accept, especially people with a normal bite. 

Nowadays, surgery seems to be a very rare treatment as it comes with many side effects. However, surgical intervention is the preferred option for children whose sleep apnea is caused by enlarged tonsils or adenoids in the nose. Surgery is also recommended for adults who have enlarged tonsils. Based on the location and nature of the airway obstruction, the surgery can be minimally invasive or more complex. 

Last but not least, in order to get some relief from sleep apnea symptoms, you might need to adjust your sleeping habits and avoid sleeping on your back. 

In a nutshell, snoring can be a symptom of sleep apnea. So, if you suspect you have this sleep disorder, make sure you speak with your physician and undergo all necessary tests to get a proper diagnosis. 




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