Simply Snoring or Something More?

If you snore, you may know about nightly jabs in the ribs and grumbling from your bed partner, or complaints from neighbors. The noise you make can disrupt their sleep and your own. It may even be a sign of a more serious problem called sleep apnea. Read on to learn more.

Snoring Is Annoying

Snoring may harm your sleep and the sleep of your bedmate or people in other rooms. This can put a strain on your relationships. Snoring can also be the first sign of sleep apnea, a serious health condition.

Sleep Apnea Is Serious

If you have sleep apnea, your throat becomes blocked during sleep. You stop breathing for short periods of time. To breathe, you must briefly wake up. The cycle repeats many times throughout the night. Besides snoring, you may:

  • Gasp or snort in your sleep.
  • Wake up tired after a full night’s sleep.
  • Wake up with a headache.
  • Feel very sleepy during the day.
  • Fall asleep easily without meaning to.
  • Have problems with memory
  • Be cranky or short-tempered. People with sleep apnea are much more likely to fall asleep during the day, sometimes even while driving.

Sleep apnea also makes you more likely to develop certain other health problems,
such as high blood pressure, heart attack, and stroke.

A Range of Treatment Options

Your doctor can discuss with you the various treatment options for snoring and sleep apnea. Treatment can help you breathe freely again so you get a good night’s sleep.

Diagnosing the Problem

To determine the best treatment, your doctor will ask about your sleep problem and examine you. An overnight sleep study may also be suggested. This study helps show whether or not your snoring is due to sleep apnea.

History

Your doctor may ask about:

  • How long you’ve snored
  • Your sleep habits
  • How well you sleep and whether you’re sleepy during the day
  • Your lifestyle and your work
  • Medical conditions you have
  • Medications you take
  • The impact of snoring or other symptoms on your life and the life of anyone who lives with you

Physical Exam

Your doctor may check your mouth, throat, and nose. Your weight, blood
pressure, heart rate, and neck size may all be recorded. Your doctor may insert a thin, flexible tube through your nose into your throat to check the the throat tissues. You may also need lab tests and x-rays.

Your partner, if you have one, can tell the doctor what happens when you are asleep.

A physical exam looks for problems that can block the airway.

Sleep Study

A sleep study (see page 6) gives the best picture of how you breathe when you sleep. Your doctor may ask you to spend a night at a sleep clinic. Or you may be loaned a small monitor to use at home. Either way, your breathing, heart rate, oxygen level, and other functions are measured and recorded. The findings help determine which treatments will best help you.

Breathing During Sleep

When you breathe, air travels through passages in your nose and throat. When these air passages are wide enough to let air flow freely, you breathe normally. But if the passages become narrowed, you may snore. And if they become blocked and you can’t breathe, you have sleep apnea.

Nasal Structures

The septum is the wall that divides the left half of the nose from the right half. Turbinates are ridges in the nasal passage.

Throat Structures

Air flows past soft, flexible structures where the mouth meets the throat: the soft plate, uvula, tonsils, and back of the tongue. Throat muscles hold those structures in place. While you sleep, the throat muscles relax a bit. But they normally stay tight enough to keep the airway open.

Snoring

If the structures in your throat are bulky or throat muscles relax to much, the airway may be partly blocked. Air flowing through the throat makes these structures vibrate. That vibration is what causes snoring.

Sleep Apnea

Blockage in the throat can partially or completely stop air from flowing. If this happens,
the brain tells the body to wake up just enough to tighten the muscles and open the airway. This cycle may repeat many times during the night.

Problems in the Nose and Jaw

Problems in the structure of the nose may obstruct breathing. A crooked (deviated) septum or swollen turbinates can make snoring worse or lead to apnea. Also, a receding jaw may make the tongue sit too far back, so it is more likely to block the airway when you’re asleep.

Monitoring Your Sleep

Your doctor may order a sleep study as part of your evaluation. A sleep study tracks and records body functions while you sleep, either at a sleep clinic or in your own bed at home. The results of the study will help with diagnosing your problem and planning your treatment.

Overnight in a Sleep Clinic

If you spend a night in a sleep clinic, you will have a private bedroom. A technician will attach many sensors to your body, then go into another room. As you sleep, your heart rate, breathing, oxygen level, and other functions will be tracked.
A microphone and video camera will record your breathing sounds and body movements. The technician will keep watch nearby. if you need an air pressure device to help you breathe, one will be available.

Tips

Follow the instructions that the sleep clinic gives you to prepare for your sleep study. These may include:

  • Bathe and wash your hair before the sleep study. Don’t use lotions, oils,
    or makeup on your skin.
  • Stick to your routine. Ask your healthcare provider if you should do anything
    differently this night.
  • Bring your pillow, sleepwear, something to read, and anything else that will
    help you sleep well.

Getting the Results

The results of your sleep study need to be scored and interpreted. Once this is done, your doctor will discuss the findings with you. The sleep study results will show whether you have apnea. It can also tell how severe the apnea is. The findings help your doctor know which treatment or treatments may be the right ones for you.

Changing Some Habits May Help

Changing a few habits may be all you need to stop snoring and prevent mild sleep apnea. Even if you need further treatment, these changes are a good place to start.

Four Things You Can Do

The changes below may take some time and effort to become habits. But stick with them. The effort may pay off in better sleep for you and your partner.

1. Sleep on Your Side

When you sleep on your back, gravity pulls relaxed throat tissues down, blocking the airway. So sleeping on your side may reduce the blockage. That may mean less snoring and less apnea. To prevent rolling onto your back, try putting tennis balls (or other round objects) into a sock sewn onto the back of your pajamas.

2. Avoid Alcohol and Certain Medications

Alcohol or medications such as sedatives, sleeping pills, and some antihistamines relax your throat muscles more than usual. That may cause or worsen blockage, snoring,
and apnea. Avoid alcohol 3 to 4 hours before bedtime. Talk to your doctor about medications you take.

3. Lose Weight

Excess weight makes the structures in your throat more bulky and floppy. That makes breathing harder and snoring and apnea worse. Ask your doctor for a weight-loss program. Being more active throughout the day and choosing healthier foods can help you lose weight.

4. Unblock Your Nose

A blocked-up nose makes snoring and apnea worse. If you have allergies or sinus problems, ask your doctor for help. If you have nasal problems, nasal strips may make breathing easier. Smoking worsens a stuffy nose, so if you smoke, quit.

Air Pressure Treatment

Continuous positive air pressure (CPAP) uses gentle air pressure to hold the airway open. CPAP is often the most effective treatment for sleep apnea and severe snoring. It works very well for many people. But keep in mind that it can take several adjustments before the setup is right for you.

A mask over the nose gently directs air into the throat to keep the airway open. How CPAP works a small portable pump beside the bed sends air through a hose, which is held over your nose by a mask. Air is gently pushed through your airway. The air pressure nudges sagging tissues aside. This widens the airway so you can breathe better. CPAP may be combined with other kinds of therapy for sleep apnea. Types of Air Pressure Treatments

There are different types of CPAP. Basic CPAP keeps the pressure constant all night long. A bi-level device gives more pressure when you breathe in and less when you breathe out. An auto CPAP device automatically adjusts pressure throughout the night in response to changes such as body position, sleep stage, and snoring. Your doctor or CPAP technician will help you decide which type is best for you.

Getting Used to CPAP

CPAP takes some getting used to. If there's anything about CPAP you don't like, chances are there's a solution. Below are a few examples of common problems and possible solutions.

If this happens… Try this
Air pressure is uncomfortable
  • Try the device's ramp feature, which starts at low pressure and slowly raises pressure to your prescribed level.
  • Try a bi level or auto CPAP device.
Discomfort in your nose
  • Try a saline nasal spray. Ask your healthcare provider about trying an antihistamine, decongestant, or prescription nasal spray.
  • Ask for a prescription warm-air humidifier for your device. Adjust the humidification if you already use it.
  • Try a mask that sends air through the mouth instead of the nose.
  • Keep in mind that even if you do nothing, nasal stuffiness may go away within a month.
Discomfort in your mouth
  • Try a chin strap to keep the mouth closed while you sleep.
  • Try a mask that covers both nose and mouth.
  • Connect a prescription warm-air humidifier to your device. Adjust the humidification.
Discomfort in your eyes, or CPAP works less well than before
  • Adjust your headgear to stop air leaks from around the mask.
  • Replace your mask with one that fits better, is a different size, or fits inside your nostrils.
Mask is uncomfortable
  • Adjust fit and tightness of mask and headgear.
  • Put cushions at pressure points.
  • Try a mask of a different style or size.
  • Ask your provider about nasal pillows.
  • If the mask irritates your skin, try a mask of a different material.
Air pump is too loud
  • Use longer hose so the device can go on the floor or under the bed.
  • Ask the device supplier for specific advice.
  • Try a different CPAP device. Keep in mind that any device's sound is quieter and easier to tune out than snoring.

Get the Adjustments You Need.

Any CPAP setup must be tailored to meet your needs and preferences. So expect several adjustments before the setup suits you. Don't get discouraged—give it some time. Talk about your needs and wants with your healthcare provider or your CPAP technician.

Notes to the Partner

Snoring and sleep apnea affect your life, too. And you can help in the treatment of the problem. Be supportive. And encourage your partner both to get treatment and to make adjustments to treatment that are needed.

Adjusting to Changes

You can help your partner make and stick with the change of habits described on page 8. For instance, support and even join his or her exercise program. If your partner gets CPAP, he or she may feel self-conscious at first. Your support can help. Remind your partner to expect adjustments to CPAP before it feels just right. And consider joining a snoring and sleep apnea support group.

Go Along to See the Doctor

You can give the doctor the best account of your partner’s nighttime breathing and snoring patterns. Try to go along to the doctor’s
appointments. If you can’t go, write notes for your partner to give
to the doctor. Describe your partner’s snoring and sleep breathing
patterns in detail.

Tips for Sleeping with a Snorer

Until treatment takes care of your partner’s snoring:

  • Try to go to bed first. It may help if you’re already asleep when your partner starts to snore.
  • Wear earplugs to bed. A fan or other source of background noise may also help drown out snoring.