Most of us don't think of snoring as something to be overly concerned about, unless our bed partner is disrupting our sleep. However, frequent, loud snoring may be a sign of sleep apnea, a common and potentially serious disorder in which breathing repeatedly stops and starts as you sleep. Although sleep apnea is treatable, it often goes unrecognized. Learn how to recognize the warning signs of sleep apnea, how to distinguish it from normal snoring, and what you can do about it.
Sleep apnea affects the way you breathe when you're sleeping. In untreated sleep apnea, breathing is briefly interrupted or becomes very shallow during sleep. These breathing pauses typically last between 10 to 20 seconds and can occur up to hundreds of times a night.
Untreated sleep apnea prevents you from getting a good night's sleep. When breathing is paused, you're jolted out of your natural sleep rhythm. As a consequence, you spend more time in light sleep and less time in the deep, restorative sleep you need to be energetic, mentally sharp, and productive the next day.
This chronic sleep deprivation results in daytime sleepiness, slow reflexes, poor concentration, and an increased risk of accidents. Sleep apnea can also lead to serious health problems over time, including diabetes, high blood pressure, heart disease, stroke, and weight gain. But with treatment, you can control the symptoms, get your sleep back on track, and start enjoying what it's like to be refreshed and alert every day.
Obstructive Sleep Apnea (OSA) is the most common type of sleep apnea. It occurs when the soft tissue in the back of your throat relaxes during sleep, causing a blockage of the airway (as well as loud snoring).
Central Sleep Apnea (CSA) is a much less common type of sleep apnea that involves the central nervous system, rather than an airway obstruction. It occurs when the brain fails to signal the muscles that control breathing. People with central sleep apnea seldom snore.
Complex Sleep Apnea (CompSA) is a combination of obstructive sleep apnea and central sleep apnea.
As air flow stops during a sleep apnea episode, the oxygen level in your blood drops. Your brain responds by briefly disturbing your sleep enough to kick start breathing - which often resumes with a gasp or a choking sound. If you have obstructive sleep apnea, you probably won't remember these awakenings. Most of the time, you'll stir just enough to tighten your throat muscles and open your windpipe. In central sleep apnea, you may be conscious of your awakenings.
While obstructive sleep apnea can be common in children, it's not always easy to recognize. In addition to continuous loud snoring, children with sleep apnea may adopt strange sleeping positions and suffer from bedwetting, excessive perspiration at night, or night terrors. Children with sleep apnea may also exhibit changes in their daytime behavior, such as:
If you suspect your child may have sleep apnea, consult a pediatrician who specializes in sleep disorders. Once obstructive sleep apnea is diagnosed, surgery to remove the child's tonsils or adenoids usually corrects the problem.
Sleep apnea can be a potentially serious disorder, so if you spot the warning signs, see a doctor right away. An official diagnosis of sleep apnea may require seeing a sleep specialist and a home-based sleep test using a portable monitor or an overnight stay at a sleep clinic.
Not everyone who snores has sleep apnea, and not everyone who has sleep apnea snores. So how do you tell the difference between garden variety snoring and a more serious case of sleep apnea?
The biggest telltale sign is how you feel during the day. Normal snoring doesn't interfere with the quality of your sleep as much as sleep apnea does, so you're less likely to suffer from extreme fatigue and sleepiness during the day.
Your answers to this quiz will help you decide whether you may suffer from sleep apnea:Are you a loud and/or regular snorer?
Source: American Sleep Apnea Association
How to Stop Snoring:
Even if you don't have sleep apnea, a snoring problem can get in the way of your bed partner's rest and affect your own sleep quality and health. But there are plenty of tips and treatments that can help.
If you're still unsure whether your snoring is normal or something more serious, the following strategies can help you decipher the symptoms:Keep a sleep diary - Record how many hours you're spending in bed, any nighttime awakenings, and whether you feel refreshed in the morning. Ask your sleep partner to keep track of your snoring, including how loud and frequent it is. Also ask him or her to note any gasping, choking, or other unusual sounds.
Record yourself sleeping - Taking a video or audio recording of yourself while you sleep can be very informative and revealing. You can use a sound-activated audio recorder, a video camera, or software that turns your computer into a recorder.
Anyone can have sleep apnea - young, old, male, female, and even children can suffer. However, certain risk factors have been associated with obstructive and central sleep apnea.
Risk factors for Obstructive Sleep Apnea (OSA) include:
You have a higher risk for OSA if you are:
Other risk factors for OSA include certain physical attributes, such as having a thick neck, deviated septum, receding chin, or enlarged tonsils or adenoids (the most common cause of sleep apnea in children). Your airway may be blocked or narrowed during sleep simply because your throat muscles tend to relax more than normal. Allergies or other medical conditions that cause to nasal congestion and blockage can also contribute to sleep apnea.
Risk Factors for Central Sleep Apnea (CSA) include:
Like OSA, Central Sleep Apnea is more common in males and people over the age of 65. However, unlike OSA, CSA is often associated with serious illness, such as heart disease, stroke, neurological disease, or spinal or brainstem injury.
While a diagnosis of sleep apnea can be scary, it is a treatable condition. In fact, there are many things you can do on your own to help, particularly for mild to moderate sleep apnea. Home remedies and lifestyle modifications can go a long way in reducing sleep apnea symptoms.
Studies show that throat exercises may reduce the severity of sleep apnea by strengthening the muscles in airway, making them less likely to collapse.
Press tongue flat against the floor of mouth and brush top and sides with toothbrush. Repeat brushing movement 5 times, 3 times a day.
Press length of tongue to roof of mouth and hold for 3 minutes a day.
Place finger into one side of mouth. Hold finger against cheek while pulling cheek muscle in at same time. Repeat 10 times then rest and alternate sides. Repeat sequence 3 times.
Purse lips as if to kiss. Hold lips tightly together and move them up and to the right the up and to the left 10 times. Repeat sequence 3 times.
Place lips on a balloon. Take a deep breath through your nose then blow out through your mouth to inflate balloon as much as possible. Repeat 5 times without removing balloon from mouth.
If your sleep apnea is moderate to severe, or you've tried self-help strategies and lifestyle changes without success, it's important to see a sleep doctor. A sleep specialist can evaluate your symptoms and help you find an effective treatment. Treatment for sleep apnea has come a long way in recent times, so take some time to explore the new options. Even if you were unhappy with sleep apnea treatment in the past, chances are you can find something that works and feels comfortable to you.
Continuous Positive Airflow Pressure, or CPAP for short, is the most common treatment for moderate to severe obstructive sleep apnea. In many cases, you'll experience immediate symptom relief and a huge boost in your mental and physical energy. The CPAP device provides a constant stream of air which keeps your breathing passages open while you sleep. Most CPAP devices are the size of a tissue box.
If you've given up on sleep apnea machines in the past because of discomfort, you owe it to yourself to give them a second look. CPAP technology is constantly being updated and improved. The new CPAP devices are lighter, quieter, and more comfortable, so make sure your sleep apnea device is up to date.
Tips and Troubleshooting
Having trouble with your new sleep apnea device? It can take some time to get accustomed to sleeping while wearing a CPAP device. It's natural to miss sleeping the "old way," but there are things you can to do make the adjustment easier.
Make sure your CPAP device fits correctly. A correct fit makes a huge difference. Make sure the straps are not too tight or too loose and that the mask seals completely over your nose and mouth. Schedule regular appointments with your doctor to check the fit and evaluate your treatment progress.
Ease into it. Start by using your CPAP device for short periods during the day. Use the "ramp" setting to gradually increase air pressure. It's normal to need several months to get used to sleeping this way.
Upgrade your CPAP device with customized options. Customize the mask, tubing and straps to find the right fit. Ask your doctor about soft pads to reduce skin irritation, nasal pillows for nose discomfort, and chin-straps to keep your mouth closed and reduce throat irritation.
Use a humidifier to decrease dryness and skin irritation. Try a special face moisturizer for dry skin. Many CPAP devices now come with a built-in humidifier.
Try a saline nasal spray or a nasal decongestant for nasal congestion.
Keep your mask, tubing and headgear clean. To ensure maximum comfort and benefit, replace CPAP and humidifier filters regularly and keep the unit clean.
Mask the sound of the CPAP machine. If the sound of the CPAP machine bothers you, place it beneath the bed to reduce the noise. You can also try using a sound machine or white noise machine help you sleep.
PAP Device Instructional Videos
Resmed Airsense & Aircurve PAP Machine
Respironics Dreamstation PAP Machine
Other PAP Devices for Sleep Apnea
In addition to CPAP, there are other adjustable airway pressure devices that a sleep specialist may recommend:
Bilevel Positive Airway Pressure (BiPAP) devices can be used for those who are unable to adapt to using CPAP, or for central sleep apnea sufferers who need assistance for a weak breathing pattern. This device automatically adjusts the pressure while you're sleeping, providing more pressure when you inhale, less when you exhale. Some BiPAP devices will also automatically deliver a breath if it detects you haven't taken one for a certain number of seconds.
Adaptive Servo-Ventilation (ASV) devices can be used for treating central sleep apnea as well as obstructive sleep apnea. The ASV device stores information about your normal breathing pattern and automatically uses airflow pressure to prevent pauses in your breathing while you're asleep.
If you've tried CPAP and self-help tips and your sleep apnea persists, you may benefit from a dental device or surgical treatment.
Dental Devices for Sleep Apnea:
Most dental devices are acrylic and fit inside your mouth, much like an athletic mouth guard. Others fit around your head and chin to adjust the position of your lower jaw. Two common oral devices are the mandibular repositioning device and the tongue retaining device. These devices open your airway by bringing your lower jaw or your tongue forward during sleep.
Dental devices are only effective for mild to moderate sleep apnea. There are also a number of troubling side effects from using this type of treatment, including soreness, saliva build-up, nausea, and damage or permanent change in position of the jaw, teeth, and mouth.
It is very important to get fitted by a dentist specializing in sleep apnea, and to see the dentist on a regular basis for any dental problems that may occur. You may also need to periodically have your dentist adjust the mouthpiece to fit better.
Surgery as Treatment for Sleep Apnea:
If you have exhausted other apnea treatment options, you may want to discuss surgical options with your doctor or sleep specialist. Surgery can increase the size of your airway, thus reducing your episodes of sleep apnea.
The surgeon may remove tonsils, adenoids, or excess tissue at the back of the throat or inside the nose. Or, the surgeon may reconstruct the jaw to enlarge the upper airway. Surgery carries risks of complications and infections, and in some rare cases, symptoms can become worse after surgery.