Have you ever been in the same space with someone who snores in their sleep? If you have, you will certainly agree that it was not a pleasant experience. You may have to endure sleep interruptions because of the noise factor. The annoyance factor may creep in, putting a strain on existing relationships.

As we look beyond the inconvenience, snoring could point to a more serious condition such as sleep apnea but lets first differentiate between the two.

Snoring occurs when the body’s respiratory structures vibrate as a result of obstructed air movement during breathing while sleeping.

What is sleep apnea?

It is a potentially serious disorder characterized by repeated stops in breathing. It is very likely that an individual who snores loudly and feels tired even after a full night’s sleep has sleep apnea.

The most common type of sleep apnea is obstructive sleep apnea (OSA) where the airways are physically collapsed or blocked, causing the sleeping individual to stop breathing.

Central sleep apnea is the lesser common apnea and occurs when the brain is unable to signal the muscles that control breathing.

We also have complex sleep apnea which presents itself when you both obstructive and central sleep apnea.

Some facts

• Close to 100 million people worldwide suffer from sleep apnea.
• Sleep apnea is an independent hypertension risk factor.
• While sleep apnea may be prevalent in persons above the age of 50, it affects people of all ages including children.
• Women going through menopause, or those in the post- menopausal phase run an increased risk of obstructive sleep apnea.

Complications arising

Sleep apnea can cause you to stop breathing during sleep. When you stop breathing, the oxygen levels in your blood go down and carbon dioxide levels go up. This makes your heart and blood vessels work harder and can affect your heart rate and nervous system. This can lead to complications over time, such as:

• Low blood oxygen levels during sleep. These low levels as well as other factors such as fragmented sleep may lead to high blood pressure in the lungs (pulmonary hypertension) and in the rest of the body (hypertension). Close to 50% of people who have sleep apnea have high blood pressure.
• Changes in the body caused by sleep apnea increase the risk of heart failure.
• Irregular heart rhythms, such as atrial fibrillation.
• Coronary artery disease.
• A greater-than-normal number of red blood cells, which may cause the blood to thicken.
• Increased possibility of stroke, heart attack or respiratory failure.
• Sleep apnea can cause some of these conditions to progress more quickly and be more difficult to treat. Treating sleep apnea may help make some of these conditions less severe.

Treatment

Depending on the cause and the level of apnea, there are different methods of treatment. The goal of treatment is to normalize breathing during sleep.

Normalizing breathing has the following effects on apnea:

• eliminates daytime fatigue.
• removes unwanted mental health changes from apnea or lack of sleep.
• prevents cardiovascular changes caused by the excess strain of improper breathing.

Lifestyle changes

Lifestyle modifications are essential to normalizing breathing, and they are critical first steps in treatment.

They include:

• reduced alcohol and cigarette intake
• exercise and weight loss activities
• sleeping on your side

Other treatment options include:

Continuous positive airway pressure (CPAP) therapy: This is the most popular treatment for sleep apnea. It keeps the airway open by gently providing a constant stream of positive pressure air through a mask.

Some people have trouble using CPAP masks and stop the treatment before achieving any tangible and long term benefit. However, there are many measures that can be taken to make the equipment more comfortable and the adjustment period smooth. The mask and its settings can be adjusted; adding moisture to the air as it flows through the mask can relieve nasal symptoms.

Surgery: There are various surgical procedures for OSA that can widen the airway. Surgery can be used to stiffen or shrink obstructing tissue, or remove excess tissue, or enlarged tonsils. Depending on the extent of the surgery, procedures can be carried out in a doctor’s office or a hospital.

Mandibular repositioning device (MRD): This is a custom-made oral appliance suitable for individuals with mild or moderate OSA. This mouthpiece holds the jaw in a forward position during sleep to expand the space behind the tongue. This helps keep the upper airway open, preventing apneas, and snoring.

Side effects of an MRD may include jaw or tooth pain, and potential aggravation of temporomandibular joint disease.

Untreated sleep apnea and its effects can have severe consequences. Any individual with excessive daytime sleepiness or other symptoms of sleep apnea should ask a doctor about their symptoms.