Internal Medicine
My wife says my snoring could be sleep apnea. What causes sleep apnea? Is it something to worry about?
Not everyone who snores has sleep apnea. And to many people, using words like “snoring” and “lifethreatening” in the same sentence may seem exaggerated, but when snoring is a sign of sleep apnea, understanding that condition and getting treatment for it could save your life.
Snoring occurs when the muscles around the airway at the back of the throat relax, partially blocking the airway. The smaller opening causes the inhaled air to travel faster as it enters the airway, increasing the vibration of the loose tissue along the throat and creating the familiar snoring sound. Snoring can be caused by a variety of factors, including the common cold, allergies and obesity. The National Sleep Foundation estimates that 37 million Americans snore on a regular basis.
Sleep apnea occurs when the muscles relax enough to completely block the opening to the airway. This cuts off oxygen, creating a series of reactions in the body. The oxygen level in the blood drops, putting a strain on the heart and forcing the lungs to try to breathe harder to increase oxygen. As the upper airway becomes obstructed, the brain begins waking up and sends signals to the muscles around the airway causing the muscles to tense. Normal breathing is restored, allowing the body to fall back to sleep. This cycle of sleeping and awakening can be repeated up to 20 or more times throughout the night.
According to the National Institutes of Health, about one in every 25 middle-aged men and one in 50 middle-aged women have sleep apnea. Women are more likely to develop sleep apnea after menopause and, overall, the incidence of sleep apnea increases with age, affecting about 10 percent of all adults over the age of 65. These are only estimates because most people with sleep apnea have never been diagnosed and that could lead to dangerous consequences. Sleep apnea can be life threatening. Low blood oxygen levels caused by apnea increases the risk of hypertension, heart attack and stroke. Because sleep patterns are constantly disturbed, people with sleep apnea also move through the day with an increased level of fatigue or sleepiness, which affects their ability to concentrate or safely drive or operate machinery.
The first step in treating sleep apnea is to consult a physician who may recommend a diagnostic study at a sleep center. This is similar to spending a night at a hotel, with the exception that machines will monitor your heart rate, respiration, blood oxygen levels and the number of times you awaken during sleep.
Although they are sometimes prescribed, neither medications nor surgery are usually needed to treat sleep apnea. Instead, the primary treatment approach involves the use of a continuous positive airway pressure (CPAP) device. These devices use a variety of masks that fit over the nose and/or mouth that blows a constant, gentle stream of air into the airways and the air pressure is adjusted to be just strong enough to keep the airways from closing during sleep.
Originally published in The University Doctor's MedicaLink- 4/10
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