Don’t Ignore the Snore

Sleep apnea affects an estimated 22 million Americans, and an estimated 80 percent of cases are undiagnosed. When left untreated, the chronic lack of sleep and abnormal breathing pressure in the chest caused by this condition can lead to fatigue, concentration problems, reduced quality of life, weight gain, and potentially serious cardiovascular problems, including high blood pressure, heart failure, atrial fibrillation, and stroke. Sleep apnea is also associated with higher risk for type 2 diabetes and depression and affects relationships and work performance. The persistent drowsiness it causes is a factor in many traffic accidents and accidents with heavy machinery.

Clearly, a wake-up call is in order to heighten awareness of how to prevent, recognize, and treat this serious health issue.

What is Sleep Apnea? Snoring is the main sign of sleep apnea, but not everyone who snores has this condition (nor does everyone with sleep apnea snore). Sleep apnea is caused by an interruption of the flow of air while sleeping, so the typically loud snoring is associated with long pauses in breathing followed by gasping, choking, or snorting.

The most common form of this condition is obstructive sleep apnea (OSA), which occurs when the airway at the back of the throat becomes blocked, reducing or completely stopping breath. Excess weight can contribute to upper airway obstruction in OSA, according to Aarti Grover, MD, Medical Director of the Center for Sleep Medicine at Tufts Medical Center. “Upper airway obstruction is closely associated with a patient’s body mass index,” says Grover. “The higher the body mass index, the higher the OSA severity, research shows.”

Use of sedatives, including alcohol, can cause the tissues in the throat to relax and obstruct the airway, and smoking, which can cause inflammation in the upper airway, may increase risk of or worsen OSA. “According to a study,” Grover says, “current smokers were nearly three times more likely to have OSA than past or never smokers.”

OSA is more common in men than women, and most often seen in older adults, although it can occur at any age. Nasal congestion, sleeping on your back, low thyroid function, and family history (your genes) may contribute as well. “We can’t control our genetics, but getting treatment early may prevent comorbid conditions in the future,” says Grover.

Many people are unaware they snore or consider it normal and never tell their doctor. Beyond chronic snoring, excessive daytime sleepiness is the most obvious symptom, as well as complaints of restless and unrefreshing sleep. Morning headaches, dry mouth, sore throat, irritability, short attention span, or difficulty thinking clearly are possible symptoms to watch for.

What to Do. If you or a loved one have any of these symptoms or are having sleep problems, Grover recommends talking to your primary care physician or seeking consultation with a sleep medicine specialist. Your healthcare provider will likely begin with a sleep history and physical examination to identify symptoms and may then recommend an overnight sleep study to analyze your sleep and breathing.

If you’re diagnosed with sleep apnea, treatment can improve sleep and prevent long term health complications. Nightly use of a breathing machine or mouthpiece, surgery, and medications may be recommended.

Lifestyle improvements are often the most effective treatment and usually involve following a healthy dietary pattern, limiting alcohol intake, and engaging in regular physical activity, all of which can help lead to a healthier weight.

We all know the challenge just one night of poor sleep brings to the next day. Sleep apnea negatively impacts quality of life every single day—and increases risk of cardiovascular problems that can shorten your life. Knowing the signs to watch for in ourselves and our loved ones is the first step to diagnosing and treating this dangerous and mostly preventable condition.