Health@Heart
Snoring and Sleep Apnea
Usually associated with snoring, sleep apnea means the cessation of breathing during sleep. This breath-holding initially lasts for 10 seconds and progresses to 20 to 30 seconds, and each episode is immediately followed by gasping for air. This cycle could repeat itself several times (20 to 100 times per hour) the whole night long. The snorer is totally oblivious of all this and only the roommate is aware of this bothersome snoring and scary sleep apnea.
How prevalent is sleep apnea?
The incidence is about 2% among middle-aged women and 4% among men of that age group, which is similar to the incidence of diabetes and asthma. Sleep apnea is a primary risk factor for hypertension (high blood pressure).
What effects does sleep apnea have?
The person wakes up with a dry mouth and throat, perhaps with a headache, and a lousy feeling akin to a hungover. There may also be fatigue and sleepiness throughout the day, together with some memory deficiency, poor attention and concentration, and bad mood —- all signs of lack of sleep, due to sleep apnea. The psychological stress of all this impacts negatively on the individual. The recurrent transient hypoxemia (low blood oxygen level) and daily impairment of sleep are added risk factors for the development of hypertension and coronary heart disease.
What causes snoring?
In some people, especially after middle age, the muscles of the upper airways in the back of the throat, like the soft palate (the back end of the roof of the mouth), the uvula (tiny appendage that hangs down), tonsils, adenoids, become flabby and vibrate with the airflow, causing the various classical noises of snoring. They also cave in and out (like a floppy valve) with respiration, blocking the upper airway and causing sleep apnea.
Are “snore stoppers” effective?
“Snore aids” advertised in the various media, such as nostril clips, nasal or throat sprays, magnetic wrist bands do not work to stop snoring, much less cure sleep disorders. Only those fraudulent vendors who make bundles of money by duping the ignorant public could sleep well, minus their conscience. One contraption, the jaw sling, which prevents the jaw from dropping while the person is asleep, shows promise for some snorers, but uncomfortable to wear.
What is the non-specific therapy?
Weight loss for those who are overweight can minimize the episodes of sleep apnea. Avoidance of sleeping pills, sedatives and alcohol, all of which increase the frequency and duration of sleep apnea, is most essential. Lying flat on the back induces sleep apnea for a lot of people. This could be avoided by placing a pillow at the back and lying on the side.
What are the various treatment regimens?
The three modalities are: (1) Physical or Mechanical, (2) Surgery, and (3) Non-specific therapy. The specific prescription depends on the medical examination and laboratory findings. The physical or mechanical treatment works only when used as the patient sleeps and apnea returns when the regimen is not utilized. There are two forms: Continuous Positive Airway Pressure (CPAP) and Dental/Oral Appliances. CPAP, the most commonly prescribed, uses a snugly fitted face mask where continuous positive pressure air is blown into the nose, forcing the airway to stay open for proper breathing. Dental/oral appliance, which is fitted by an ortho dentist, uses a device that moves the lower jaw forward to cause an under bite, which opens the airway.
What medical conditions contribute to sleep disorders?
There are many impairment of sleep due to a variety of medical ailments, like emphysema congestive obesity, heart failure, diabetes, stroke, and others conditions associated with pains like cancer, arthritis, acid reflux in the esophagus (food pipe). Anxiety disorders and depression are also associated with sleep disturbances. Consultation with a sleep specialist is critical for proper diagnosis and management of these disorders.
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