What Causes Snoring?
Snoring is a sound made by vibrations of excess soft tissues in the back of the nose and throat that include the soft palate, uvula, the tonsils, and the back of the tongue. When we go to sleep, the brain tells the body to relax. The muscles surrounding our throat also become more relaxed and vibrate more easily when we breathe during sleep. The vibrations that occur while we breathe in our sleep result in the sounds we know as snoring. Snoring by itself is not dangerous, although it can be harmful to your relationship with your bed partner! What is more harmful to your health is if your snoring is associated with “obstructive sleep apnea.”
What is Obstructive Sleep Apnea?
Obstructive sleep apnea (OSA) occurs when the airway becomes blocked by the collapse of the relaxed throat or nasal tissues when breathing during sleep. When there is significant blockage, the brain senses this and arouses the person from the different stages of sleep. When people don’t get enough of the deeper stages of sleep, they can have daytime fatigue, sleepiness, and even insomnia. Other symptoms of OSA include, grinding the teeth, morning headaches. This can happen to children as well since many children have big tonsils and adenoids that can block their airways. In children, obstructive sleep apnea may be manifested by bed wetting, daytime irritability, and hyperactivity.
How is Obstructive Sleep Apnea Harmful to your Health?
Compared to the general population, patients with obstructive sleep apnea have increased risk for car accidents, heart attacks, and strokes. Since the brain is constantly arousing the patient at night time and activating the “fight or flight” response, this can contribute to elevating blood pressure. Obstructive sleep apnea also makes the heart work harder and this can lead to heart failure and cardiac arrhythmias. It also disrupts our circadian rhythms and disrupts hormones associated with them.
How is Obstructive Sleep Apnea Diagnosed?
Sleep disorders are diagnosed in a sleep lab. Patients spend the night in the sleep lab where monitors are used to record your breathing, heart rhythm, oxygen level, and body movements, while you are asleep. The number of times there are blockages that cause arousals are recorded to determine if the patient has sleep apnea and how severe it is.
In certain patients, an in-home sleep study can be done by wearing a device that measures, however this provides less information than an in-lab sleep study.
How is Obstructive Sleep Apnea Treated?
Obesity is a strong risk factor for obstructive sleep apnea. Excess weight around the neck makes the airway in the throat more collapsible during sleep. Men who have neck sizes greater than 17 and women with neck sizes greater than 15.5 are predictive of OSA. This means that weight loss can help decrease the severity or even cure sleep apnea!
For patients with mild sleep apnea. Dental devices can be fitted by a dentist to reposition the jaw forward so that the tongue does not collapse the airway during sleep.
The gold standard for treatment of OSA is a device called Continuous Positive Airway Pressure or “CPAP.” The patient wears a mask that is connected to the machine that blows air into the airway to prevent the airways from collapsing. To be maximally effective, one should wear the device all night.
CPAP can be used for mild, moderate, or severe obstructive sleep apnea.
What if you can’t tolerate using CPAP?
In certain patients, surgeries involving the airway can decrease the severity or even cure sleep apnea depending on the site of suspected obstruction. Surgery can also help a patient better tolerate the CPAP machine. If nasal blockage is a major factor, surgeries such as septoplasty and turbinate reduction may be beneficial. If the back of throat is the suspected area of collapse, procedures such as uvulopalatopharyngoplasty “UPPP” that remove the tonsils and excess soft tissue of the uvula and palate may be beneficial. To address the collapse of the back of the tongue, procedures such as tongue base reduction, hyoid suspension, and genioglossal advancement may be beneficial.
Potomac Ear, Nose and Throat has physicians that are board certified in Sleep Medicine. All of the physicians are trained to perform airway surgeries to treat sleep apnea. If you think you have obstructive sleep apnea, call today for an evaluation with the physicians at Potomac Ear, Nose and Throat at 703-499-8787