Sleep Apnea

Pulmonology, interventional Pulmonology And Sleep Medicine
Pulmonology, Interventional Pulmonology and Sleep Medicine

Snoring and Obstructive Sleep Apnea

"Why do I snore loudly and feel tired and irritable even after a full night's sleep?" 
The answer is - You might have sleep apnea.

What is Snoring- A quick guide

We find it unbelievable that we only snore at night and not during the day, but why is that the case? During the day, our neck muscles keep the airway broad and help air pass through the nose and throat smoothly. Meanwhile, neck muscles loosen during sleep and collapse into this airway, narrowing it and causing airflow turbulence. The suction current created by the rapid airflow vibrates and stretches the uvula and soft palate. Due to the negative pressure pulling the tongue back and blocking the airway, this force causes snoring and sleep apnea.

Snoring can happen at various levels starting from the nose to the oropharynx (back of your mouth)

  1. Air from outside transits to the nasopharynx via the nose. Any obstruction in this passage will cause snoring. The deviated nasal septum that blocks the airway is one of the major causes. Patients with difficulty breathing through the nose tend to sleep with their mouths open at night, which causes turbulence of airflow as it bypasses the nose and results in snoring.
  2. Similar causes of snoring are Allergic rhinitis and nose block, Sinusitis with nasal polyps, tumors of the nasal cavity.
  3. Patients with tonsillar hypertrophy will also experience snoring because of the same phenomenon. Here, airflow obstruction is at the level of the oropharynx.
  4. In obese patients, there will be increased neck circumference due to fat deposition, shorter neck, and loose neck muscles. These are contributing factors to increase the turbulence of airflow and snoring.
  5. Acidic reflux in the long-term causes elongation of the uvula and edema of the mucous membrane of the throat. The movement of the long uvula with breathing will also cause turbulence and snoring.

How loud do I snore?

Usually, snoring is reported by your partner/ roommate. There are several ways to assess the loudness of snoring with the help of questionnaires.

What are the treatment options?

A qualified ENT surgeon will evaluate you to assess the causes of snoring. Treatment options aim at creating a smoother airway during sleep. Lifestyle changes can achieve a holistic approach toward the reduction of snoring.

In cases of obstruction at the nose level, like a deviated septum, allergic rhinitis, or nasal polyps, the treatment aims to clear the disease and create a nasal pathway for the smooth conduct of air.

Some doctors recommend a balloon sinuplasty procedure to reduce the forces that create vibration, snoring, and sleep apnea. However, balloon sinuplasty is considered ineffective in reducing sleep apnea symptoms. Balloon sinuplasty has a higher risk of complications and an extended recovery period. Today there are procedures to stiffen or soften the soft palate that can reduce snoring and open the airway in the back of our throat.

In some cases, an oral appliance may also be needed to assist in holding the mouth closed and move the jaw slightly forward to shift an oversized tongue away from the back of the throat.

What's beyond snoring? Have you heard of Obstructive sleep apnea?

In some people, the throat closes so much that not enough air can get through to the lungs, and when this happens, the brain sends an alarm to open the airway. The brain quickly reactivates the muscles that hold the throat open. Air gets through again, and our brain goes back to sleep. Most often, this is associated with brief arousal from sleep. When we experience this disorder, the term given to it is "obstructive sleep apnea."

In this process, the person tends to keep his mouth open to breathe easily. Mouth breathing also dehydrates the tongue, which results in progressive tongue enlargement, increasing the chance of sleep apnea.

Do I have Obstructive sleep apnea? Check it out!!

Symptoms of obstructive sleep apnea:

  • Excessive daytime sleepiness
  • Loud snoring
  • Observed episodes of stopped breathing during sleep
  • Abrupt awakenings accompanied by gasping or choking
  • Awakening with a dry mouth or sore throat
  • Morning headache
  • Difficulty concentrating during the day
  • Mood changes, such as depression or irritability
  • High blood pressure
  • Decreased libido

Factors that increase the risk of sleep apnea include:

  • Excess weight. Obesity dramatically increases the risk of sleep apnea.
  • Neck circumference. People with thicker necks might have narrower airways.
  • A narrowed upper airway.
  • Shorter jaw
  • Double chin
  • Being older.
  • Family history.
  • Use of alcohol, sedatives, or tranquilizers.
  • Smoking.
  • Nasal congestion/ Nasal block
  • Medical conditions like diabetes, Parkinson, etc.,

Lifestyle changes to adapt

Few lifestyle changes and home remedies that can help you.

  • If you're overweight, try to lose weight.
  • Sleep on your side.
  • Raise the head of your bed.
  • Treat nasal congestion or obstruction.
  • Limit or avoid alcohol and sedatives.
  • Quit smoking today.
  • Get enough sleep.

You can visit your doctor if you have or if your partner observes the following:

  • Snoring loud enough to disturb your sleep or that of others.
  • Waking up gasping or choking
  • Pausing your breathing during sleep
  • Treat nasal congestion or obstruction. Having excessive daytime drowsiness, which may cause you to fall asleep while working, watching television, or even driving a vehicle.

Is treatment for Obstructive sleep apnea necessary?

Obstructive sleep apnea is considered a severe medical condition.

  • Daytime fatigue and sleepiness. Patients might find it challenging to concentrate and fall asleep at work while watching TV or even when driving. This can put them at higher risk of work-related accidents.
  • Cardiovascular problems: Many people with obstructive sleep apnea develop high blood pressure, which can increase the risk of heart disease.
  • The more severe obstructive sleep apnea, the greater the risk of coronary artery disease, heart attacks, heart failure, and strokes.
  • Obstructive sleep apnea increases the risk of abnormal heart rhythms (arrhythmias), which can lower blood pressure.
  • Complications are also seen with medications and surgery. These medications, such as sedatives, narcotic analgesics, and general anesthetics, relax your upper airway and can worsen your obstructive sleep apnea.
  • If you have obstructive sleep apnea, having major surgery, especially after being sedated and lying on your back, can worsen breathing problems. People are prone to complications after surgery.
  • Before surgery, tell your doctor if you have obstructive sleep apnea or symptoms related to the condition. Your doctor might want you tested before surgery with a sleep study.
  • Eye problems. Some research has found a connection between obstructive sleep apnea and certain eye conditions, such as glaucoma.
  • Sleep-deprived partners. Loud snoring can keep those around you from getting good rest.
  • Patients may also complain of memory problems, morning headaches, mood swings or depression, and a need to urinate frequently at night.
  • Children and young people may display attention or behavior problems.
  • Individuals with obstructive sleep apnea are at higher risk for developing a severe form of COVID-19 and needing hospital treatment than those who don't have obstructive sleep apnea.



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