When Snoring Is More Than a Bad Soundtrack
Roaring snores that rumble a room or violent snorts for breath during sleep could be sounds of obstructive sleep apnea. While a true diagnosis is only possible with a sleep study, if left untreated, the sleep disorder could be fatal.
Typical symptoms include shallow breathing or stoppage in breathing while asleep. Sufferers can stop breathing for periods of seconds or minutes - upward of hundreds of times a night in some cases.
Though everyone is susceptible, overweight people are 70 percent more likely to suffer from it, says Dr. Philip Alapat, medical director, Sleep Disorders Center, Harris County Hospital District, and assistant professor, Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine.
As head of the Harris County Hospital District Sleep Disorders Center, a nationally certified facility by the American Academy of Sleep Medicine, Alapat sees hundreds of overweight and obese patients suffering from the deadly sleep disorder. Annually, the center performs about 1,200 studies to evaluate patients for a variety of sleep disorders, including apnea, insomnia, restless legs syndrome, narcolepsy and chronic fatigue syndrome.
“A cardinal recommendation physicians make to overweight or obese patients suffering from obstructive sleep apnea is to lose weight. Losing weight usually reduces or eliminates some of the effects and symptoms. We see it all the time, people who lose weight see an improvement, but people who gain weight have a worsening of symptoms,” he says.
Aside from a restless sleep, sufferers increase their risk for high blood pressure, diabetes, heart attacks and stroke.
Signs of obstructive sleep apnea include:
• Repeatedly tired
• Dosing off during work, driving or other activities
• Lack of concentration when performing activities
• Fatigued even after sleeping the recommended 7-8 hours a day
Snoring Is Not Necessarily Sleep Apnea
It is important to distinguish between snoring and OSA. Many people snore. It’s estimated that approximately 30% to 50% of the US population snore at one time or another, some significantly. Everyone has heard stories of men and women whose snoring can be heard rooms away from where they are sleeping.
Snoring of this magnitude can cause several problems, including marital discord, sleep disturbances and waking episodes sometimes caused by one’s own snoring. But, snoring does not always equal OSA; sometimes it is only a social inconvenience. Still, even a social inconvenience can require treatment, and there are several options available to chronic snorers.
The sleep disorder is twice as likely among men and is more common among smokers, sufferers of chronic nasal congestion and hypertension. However, being overweight is still the biggest risk factor.
“We know that diagnosing and treating obstructive sleep apnea improves one’s ability to live longer and improves other aspects of a person’s life like managing high blood pressure and diabetes,” Alapat says.
Diagnosing Sleep Apnoea
Obstructive Sleep Apnoea (OSA) can range from very mild to very severe. The severity is often established using the apnoea/hypopnoea index (AHI), which is the number of apnoeas plus the number of hypopnoeas per hour of sleep - (hypopnoea being reduction in airflow). An AHI of less than 10 is not likely to be associated with clinical problems. To determine whether you are suffering from sleep apnoea you must first undergo a specialist ‘sleep study’. This will usually involve a night in hospital where equipment will be used to monitor the quality of your sleep. The results will enable a specialist to decide on your best course of treatment. The ultimate investigation is polysomnography, which will include:
- Electro-encephalography (EEG) - brain wave monitoring
- Electromyography (EMG) - muscle tone monitoring
- Recording thoracic-abdominal movements - chest and abdomen movements
- Recording oro-nasal airflow - mouth and nose airflow
- Pulse oximetry - heart rate and blood oxygen level monitoring
- Electrocardiography (ECG) - heart monitoring
- Sound and video recording
This is a very expensive investigation, with few centres able to offer it routinely for all suspected sleep apnoea patients. A ‘mini’ sleep study is more usual, consisting of pulse oximetry and nursing observation.
Some treatment options for obstructive sleep apnea include lifestyle changes, corrective mouthpieces, breathing devices or surgery to open up blocked airway passages.
The Harris County Hospital District Sleep Disorders Center is jointly staffed by physicians from Baylor College of Medicine and The University of Texas Health Science Center at Houston.
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Source: Harris County Hospital District