My Grandmother found my Uncle face down in a bowl of cereal, sound to sleep, when he was in college.  That same Uncle took us to the Red’s game and fell asleep on the floor of the stadium restaurant right in the middle of the 5th inning. He would do laundry all night long and fall asleep mid conversation during the day. I’ve known that he has sleep apnea my whole life. What I didn’t know is that his sleep apnea would put him in the hospital with heart failure and a cardiac arrhythmia. Read about link between heart disease and sleep apnea.
Sleep apnea is a serious medical condition that can also lead to hypertension, weight gain, impotence, headaches and memory problems. It is very common with 1 in 5 adults have some form of snoring or sleep obstructions yet 85% these go undiagnosed and untreated. People with sleep apnea are far more likely to get in car accidents and let us not forget about the bed partners whose own sleep (& sanity) are affected by the snoring.

Who is at risk for snoring and sleep apnea?
Risk factors for snoring include males, age between 40 and 64 years, obesity, and current cigarette smoking. Sleep apnea can occur in women and even children. A recent study showed that sleep apnea might actually cause more markers for heart inflammation in women than in men.

What causes snoring and how can it be dangerous?
When you sleep the muscles and soft tissues in your throat and mouth relax. The lower jaw and tongue may drop back. This can increases the speed of the air moving through your airway when you breathe, causing the soft tissues in your mouth and throat to vibrate.  The snoring sound is actually the sound of those tissues vibrating.

In its most severe form, the upper airway collapses completely so the lungs do not receive any air.  This is called “Obstructive Sleep Apnea” which literally means “without breath.”

Some may stop breathing for 10 seconds or even over a minute. In response to this deprivation of oxygen, the heart has to work harder. Finally, the body triggers an internal alarm when you don’t have oxygen to wake up and gasp for air. People with sleep apnea may have 100’s of these episodes a night.

This constant oxygen deprivation has been shown to cause hypertension as your blood vessels constrict or tighten up trying to get more oxygen.  Half of all sleep apnea patients will have hypertension and up to 30% of people with hypertension have sleep apnea. This can lead to heart failure, weight gain, heart arrhythmias, impotence, headaches, memory problems, moodiness and constant feelings of fatigue.

What are the types of sleep apnea?

There are 2 types.

Obstructive Sleep Apnea is the most common and caused by blockage of the soft tissue around the airway. This is increased with smokers and obese people.

Central sleep apnea is less common and is caused by the nervous system not taking a breath properly. Many of these people are not obese but disruptive sleep patterns increase chemical messengers to eat and lead to obesity.

How do I know if snoring is a problem?



The first step for everyone with snoring, daytime fatigue or restless legs is a sleep study to determine what kinds of sleep disruptions are occurring. This is usually done in a separate sleep lab.

Do you need a sleep study?
Click here to take a quick quiz from the Sleep Apnea Association

After a sleep study most will be diagnosed with sleep apnea but for simple snoring there are a few treatments.

Simple snoring can be treated by

Avoiding alcohol and sleeping pills (except ramelteon)
Losing weight (if overweight)
Sleep lying on one side
Stop smoking
Snoreguard
Some patients may benefit from an oral appliance that repositions the tongue or jaw so that airflow is not restricted. This is called a snoreguard and is fit by a dentist.

Pillar Procedure

I spoke with Dr. Mark Duetsch, a local ENT specialist who performs the Pillar procedure that is FDA approved for snoring and mild to moderate sleep apnea. It is an office procedure and not typically covered by insurance but has been very effective in his snoring only patients.

What is the best treatment for Sleep Apnea?

If sleep apnea is diagnosed, the most common treatment is Continuous Positive Airway Pressure (CPAP). It gently pushes the flow of positive-pressure air through a mask to open the airway during sleep. The result is that breathing becomes regular, snoring stops and a restful sleep is restored. There are many types of devices and the sleep study can determine which is the best for you.

CPAP can take a while (months) to tolerate. They now make CPAP machines with humidifiers to release water and prevent drying as well as aromatherapy. They can also slowly bring up the pressure so it is easier to tolerate.

Some cannot tolerate CPAP at all and an ENT or Oral Maxillofacial Surgeon can provide further help. A surgical procedure can be done to increase the size of the airway by removing any obstruction such as enlarged tonsils, polyps or growths that may be blocking it. An unusually formed jaw may be causing the problem and can be corrected with surgery.

The most important thing is to TREAT the snoring and sleep apnea. Not only may it be causing damage to your marriage but poses serious health risks to you that are PREVENTABLE with treatment.

Dr. Deb