Aside

Could Your Snoring be an Indicator of Something More Sinister?

Hey there Guys,

Today I wanted to talk about one topic that is very common and rarely diagnosed, despite the huge improvement in health that can come from treatment.

Do you snore?

Do you frequently feel sleepy during the day?

Has your partner or significant other ever said you stop breathing at night?

If you have any of these three common symptoms you may be suffering with sleep apnoea, a disease where, due to a variety of reasons, the throat and upper airway can close leading to people stopping breathing. By definition an apnoea episode is when someone stops breathing for more then ten seconds. In reality many people stop breathing for 30 seconds or more!

You can imagine that if you were to stop breathing constantly throughout the night you can feel pretty lousy during the day.

So what is sleep apnoea?

As briefly mentioned above, obstructive sleep apnoea (OSA) is a disease where breathing is greatly disturbed during the sleep process. Sleep apnoea is actually quite common, however over 80% of sufferers live their life undiagnosed.

In majority of cases the cause of sleep apnoea is a combination of having a small airway, big tonsils and tongue, and lax support structures at the back of the throat. As sufferers sleep their tongue falls backwards and blocks off the ability for air to flow through the mouth or nose into the lungs.

what is sleep apnoea

At this point oxygen levels in the body start to plunge, and waste carbon dioxide levels start to rise . When the carbon dioxide levels reach a certain threshold the brain senses an emergency and wakes the person up to help start the breathing again. If you have ever witnessed a partner having an episode this is normally the “snorky” startling sound that is made after an extended period of not breathing.

Sufferers of sleep apnoea go through repeated cycles of falling asleep, airway blocking off, stopping breathing and then waking up, sometimes more then 30 cycles per hour. This leads to very poor quality sleep and the body being forced to cope with very low levels of oxygen in the blood.

Doctors may consider a diagnosis of sleep apnoea with any or all of the following symptoms:

  • day time sleepiness
  • poor concentration and ability to think
  • low mood and irritability

When suffered for many years, sleep apnoea can lead to organ damage and even changes in the blood to cope with long term low oxygen levels. Sleep apnoea has also be associated with high blood pressure and chronic stress on the body that makes weight loss difficult.

Who is at risk of sleep apnoea?

If you are a member of the bear community you already have one of the risk factors – being male.

Increased weight is also a risk, with neck size being a major contributor. If your neck circumference is more then 43cm (17″) you are at greater risk.

It is worth noting, however, that slim people can also experience sleep apnoea.

Other risk factors include having a crowded space at the back of the throat, with large tonsils and tongue being the main cause. If you have ever had any damage to the facial bones, this can also be contributing factor.

Having a blocked nose, even if you are able to breath through your nose, doubles the risk of OSA.

Smoking triples the risk of OSA.

Alcohol, because it tends to relax the muscles at the back of the throat, makes the risk of obstruction worse.

It is normally the partner of a sufferer who makes the diagnosis, reporting that their partner is frequently snoring and has episodes where they stop breathing.

A simple way to remember the symptoms of sleep apnoea are “the three S’s”

  • Snoring
  • Sleepiness during the day
  • Significant other reporting disturbed sleep and apnoea episodes.

If you think you may be suffering from OSA you can check out the Epworth Sleepiness Scale. I suggest printing it out and sharing it with your doctor.

How is sleep apnoea diagnosed?

If you suspect you may be suffering with sleep apnoea the best person to talk with would be your family doctor. They are able to talk about what you have noticed, check your blood pressure and give you a brief physical exam. The gold standard to diagnose sleep apnoea is a sleep study.

A sleep study is normally done in the setting of a hospital. You will need to arrive in the early evening and you can expect to leave by about 7-8 in the morning. During your stay you will have your breathing, heart, and oxygen levels monitored as you sleep, to record episodes of apnoea as they occur.

If you have private health insurance this is normally covered, however discuss this with your provider if you are not sure.

There are home sleep studies available as well, however it is uncertain how helpful the data from these studies are.

What is the treatment of sleep apnoea?

CPAP MachineThe best treatment for sleep apnoea is the use of a CPAP (Continuous Positive Airway Pressure) machine.

CPAP treatment consists of a machine and a mask that is worn while you sleep. While the inital adjustment can take a few days many people report that the change is amazing. To quote a mate of mine:

I was having apnoea events 78 times an hour. I was spending more than three quarters of the night below 80% blood oxygenation.

The doctor said is was miraculous I was as highly-functioning as I have been.

Needless to say after a night on the CPAP I felt like a different person.

Most people report feeling more energetic with an increase in concentration and thought process. Daytime sleepiness is also reduced as the body returns to a normal sleep pattern.

Although there may be an initial awkwardness adjusting to the machine, the majority of users are so happy with the result they can’t imagine living without it.

Other suggestions to help improve sleep include weight loss and avoiding alcohol at night, as this makes the upper airway and throat more likely to collapse.

Take home points…

  • Sleep apnoea is very common with more then 4 out of 5 people never being diagnosed
  • The main symptoms of sleep apnoea include: Snoring, Sleepiness and Significant others witnessing the sufferer stopping breathing throughout the night
  • Main risks of OSA include being male, being overweight, a neck circumference more then 43cm and a throat that is crowded with a large tongue and tonsils.

If you are concerned you may be suffering with sleep apnoea the best person to talk with is your family doctor who can help organise a sleep study to evaluate your breathing as you sleep.

The good news is that with treatment, sleep apnoea can be reversed and this can help improve energy levels, your ability to think and even help with blood pressure reduction and weight loss.

Certainly something to consider.

Yours in good health.

Dr George

Photo Credit: Mattastic!

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