Its raining! Its pouring! The old man is SNORING!

Except that – young and old, women and men are all prone to snoring. Approximately 1 in 6 women and 1 in 4 men are reported to snore regularly. And while snorers may be well aware of their sleep-sabotaging impact on partners; most are unaware of the health risks that they themselves may suffer.

So what causes snoring?

Snoring occurs as a result of obstruction to the flow of air through the mouth and nose. This may occur due to:

  • Obstructed nose: Deformities of the nose such as a deviated septum (a structural change in the wall that separates one nostril from the other) or nasal polyps can also cause obstruction. Sinus infection or allergies can also cause obstruction.
  • Poor muscle tone in the throat and tongue: This can lead to tongue muscles to fall back into the airway causing obstruction. Exacerbating conditions include deep sleep, alcohol and drug use, and normal aging.
  • Bulky throat tissue: Being overweight or obese can cause bulky throat tissue.

 

What is sleep apnea?

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When a snorer repeatedly stops breathing for brief moments, that’s when trouble ensues! When a person may experience pauses in breathing five to 30 times per hour or more during sleep, he/she is diagnosed with sleep apnea. These episodes wake the sleeper as he or she gasps for air. It prevents restful sleep and is associated with several cardiovascular risk factors including high blood pressure, rhythm disorders, stroke and even heart attacks!

Sleep apnea can be of two types – obstructive sleep apnea (OSA) and central sleep apnea (CSA). CSA is much less common and is a result of problems with the brain signaling your muscles to breath. OSA, on the other hand, is much more common and occurs as a result of blocked airways – the same mechanism as that for snoring. OSA is more prevalent in obese individuals, and in men more than women. 1 in 5 adults suffer from OSA.

What are the symptoms of OSA?

OSA can manifest with the following symptoms – snoring, headaches, daytime sleepiness, forgetfulness, and depression. In extreme cases, it can lead to increased blood pressure in the lungs (called pulmonary hypertension), which in turn leads to heart failure – with symptoms of shortness of breath, fatigue, and leg swelling.

How does OSA affect the heart?

A picture is worth a thousand words…

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How is it diagnosed?

The diagnosis encompasses a complete medical history and physical examination. There are some screening questionnaires that you may be asked to fill at your doctor’s office that may be suggest the possibility of the diagnosis. The gold standard of the diagnosis, however, is a polysomnogram.

A polysomnogram usually requires that you stay overnight in a hospital or a sleep study center. While you sleep, it will measure the activity of different organ systems associated with sleep. It may include measurement of brain waves, called electroencephalogram (EEG), eye movement called electro-oculogram (EOM), muscle activity called electromyogram (EMG), heart rate and rhythm called electrocardiogram (ECG) and oxygen levels in your blood. And while all this is happening – you are expected to sleep normally – as if you were in your comfy bed! This is not a joke! Really!

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Good news… and Bad news!

Well, the good news is that OSA can be treated fairly well. Bad news is that it aint easy!

  • Weight loss – Told you. Not easy. But if you did manage to shed those pounds, then success rate is very high.
  • Continuous Positive Airway Pressure – This is the first line of treatment for OSA. It is administered through a facemask that’s worn at night that delivers positive airflow to keep the airways open at night. It is highly effective, albeit slightly inconvenient.

CPAP

  • Surgery – The last resort for severe cases is uvulopalatopharyngoplasty – which is a sesquipedalian way of saying – to surgically remove extra tissues at the back of the throat.

If there is one takeaway from this post, it is that – if you snore at night and feel tired during the day – get checked for sleep apnea! Your heart, and your partner, will heart you!

If you have any questions about sleep apnea or the heart in general, click here.

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