Posted on
01 April 2010, under
Health; More Health articles...
Pillow talk!
Snoring is basically caused by wind turbulence when you are breathing in through either your nose or mouth. It occurs when air flows past relaxed tissues in your throat, causing hoarse or harsh sounds. As you doze off and progress from a lighter sleep to a deep sleep, the muscles in the roof of your mouth (soft palate), tongue and throat relax. The tissues in your throat can relax enough that they vibrate and may partially obstruct your airway. The narrower your airway, the more forceful the airflow becomes. Tissue vibration increases and your snoring grows louder. Snoring may be an occasional problem or it may be habitual. Snoring is common, especially in men, about half of all men snore at some stage and about 25 percent of men snore regularly.
The main health consequence of snoring is disturbed sleep of the spouse and/or household and it is a recognised cause of marital disharmony. However, snoring can also be a serious health issue for men.
Sleep Apnoea Syndrome:
Sleep apnoea syndrome is a potentially serious condition that is seen in some men who snore. This is where the throat tissues block the airway and prevent you from breathing momentarily. When this happens the blood oxygen level falls and carbon dioxide level rises, which causes arousal, making the person suddenly snort or grunt, heralding the return of breathing. Sleep apnoea syndrome is characterised by these spells of lid snoring followed by episodes of silence.
The problem is that this mechanism prevents somebody from getting deep refreshing sleep and they suffer from the clinical effects of sleep deprivation, including daytime drowsiness or sleepiness, poor concentration, headaches and irritability. In addition, sleep apnoea syndrome has adverse effects on the heart and blood pressure, leading to an increased risk of heart arrhythmia, heart attack and stroke.
Clues to Sleep Apnoea:
Nearly all men who suffer from sleep apnoea syndrome are snorers, however many snorers do not have sleep apnoea syndrome. Feeling tired, drowsy or sleepy during the day is a major clue to the existence of sleep apnoea syndrome. Ask your spouse / partner if there are any periods during snoring when your breathing tapers off or stops, with silence for a few seconds or more, followed by a grunt or a gasp.
The presence of this is highly suggestive of sleep apnoea syndrome. Other symptoms include poor concentration, irritability and reduced daytime performance. Sleep deprivation can also produce a whole range of other symptoms, from sexual dysfunction to sleep walking.
What Contributes to Snoring?
A variety of factors can lead to snoring including:
• Cigarette smoking
• Your mouth anatomy – a low, thick, soft palate and enlarged tonsils or tissues in the back of your throat (adenoids) can narrow your airway. Likewise, if the triangular piece of tissue hanging from the soft palate (uvula) is elongated, airflow can be obstructed and vibration increased.
• Being overweight or obese.
• Alcohol consumption – snoring can also be brought on by consuming too much alcohol before bedtime. Alcohol relaxes the throat muscles and decreases your natural defences against airway obstruction.
• Upper airway problems such as nasal polyps, nasal blockage or congestion, a crooked partition between your nostrils (deviated nasal septum) or a floppy palate.
Other known risk factors include allergies, using sedative drugs and rare conditions including overactive thyroid gland.
Tips to Prevent or Reduce Snoring:
Appropriate lifestyle changes are important in the treatment of snoring and sleep apnoea syndrome:
• If you smoke – STOP
• Keep your weight healthy. Excess weight is a common risk factor. Keep your body mass index within the range of 20 – 25.
• Sleep on your side: lying on your back allows your tongue to fall backward into your throat, which can partially obstruct airflow and cause snoring. Some men find sewing a tennis ball onto the back of their pyjamas can help stop them sleeping on their back!
• Adhesive nasal strips applied to your nose can help increase the size of the nasal passage and help the breathing.
• Get medical assessment and treatment for nasal congestion or obstruction. Problems with nasal allergies or obstruction are a common cause of snoring, as a blocked nose means you have to breathe through your mouth, which brings an increased risk of snoring. To correct a deviated septum you may need surgery. Restrict your alcohol intake and avoid sedatives, including sleeping tablets.
Diagnosis:
If you snore you should consult your doctor, especially if you have symptoms of sleep apnoea. A confirmed diagnosis requires you to spend a night in a specially designed sleep lab that measures the amount of oxygen in your blood during the night, amongst other parameters. Other causes of snoring, including nasal obstruction, may benefit from an opinion from an ENT (ear, nose and throat) specialist.
Treatment Options:
If lifestyle changes don’t sort out the snoring problem other options can be considered. Mouthpieces that help advance the position of your tongue and soft palate to keep your air passage open can be used. Surgical options include tightening the loose tissues in the back of the throat. Laser surgery on the soft palate can now also be an option in some cases.
The treatment of sleep apnoea syndrome has been revolutionised by the delivery of continuous positive airway pressure (CPAP). This delivers air continuously through your airway while you are sleeping. The most common form of CPAP involves wearing nasal prongs or a pressurised mask on the nose while you are sleeping. The mask is attached to a small pump that forces air through the airway, keeping it open. CPAP is extremely effective and can prevent all complications of sleep apnoea syndrome. However, like many medications or medical devices, it is only as good as the willingness or ability of the person to use it regularly.
Dr. Mark Rowe
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