Q&A: Snoring & Sleep Apnea

Question: “Every night my husband snores very loud. I have trouble falling asleep when it is real bad.  Is this serious? My friend said he needs to lose weight, what does weight have to do with this?” – Leslie

Answer:
Thanks for sharing Leslie.  Simple snoring or “stertor” or “stertorous breathing” is extremely common amongst men and women.  It is usually due to vibration of the soft palate and uvula in the back of the mouth, and can be made worse by obstructed nasal passages.  Weight can make snoring worse too, as can sleeping flat on one’s back, or having a few alcoholic beverages before bedtime.
The more serious concern is “sleep apnea” or “sleep disordered breathing”.  This usually includes snoring that progresses to pauses – or gaps – in the breathing pattern at night.  Basically the throat can temporarily collapse down and obstruct breathing.  This may sound like choking or gasping, or may be completely silent, and may often startle the patient awake for a split second.  This is bad because it lowers the blood oxygen, and raises the carbon dioxide levels.  Additionally strain is placed on the circulatory system resulting in blood pressure swings and heart rate fluctuations, and a phenomenon of pulmonary hypertension can ensue.
In the long run, sleep apnea can result in high blood pressure, high “lung blood pressure”, increased risk of sudden cardiac death and increased risk of stroke.
On a daily basis, these frequent interruptions in sleep cause the patient to feel extra drowsy in the daytime, even to the point of falling asleep at the wheel or even being so sleep deprived as to fall asleep in the middle of conversations.  Morning headaches, high blood pressure, and depression can go along with all this.
Weight can make both snoring and sleep apnea worse by making the throat easier to collapse and the lungs harder to expand.
There are good treatments aimed at snoring and sleep apnea.  Both can potentially be cured with surgical procedures.  Depending on the severity we may recommend an all-night “sleep study” (polysomnography) to really measure how bad things are.  Moderate or severe sleep apnea usually justifies a trial of a CPAP breathing machine at night to restore oxygenation when asleep.
Effective control of sleep apnea can mean greatly improving the snoring, correcting the circulatory problems, correcting the daytime drowsiness, headache, fatigue, and reducing the risk of “sudden cardiac death”.