Why do you Snore?

Virtually all of us snore from time to time. In fact, it is estimated one-third of the world population snores, and that number is increasing. For some, snoring is no more than an occasional, inconvenient habit; but chronic, heavy, loud snoring can be more serious. We all know we don't snore while we are awake, so why do we snore while asleep?

Snoring occurs when you relax during sleep, causing your lower jaw and tongue to drop back against the back of the throat. This forces the airway to narrow and constrict, lowering the amount of oxygen your body can take in. Your body reacts to this decrease in oxygen, by increasing your respiration, or breathing. This increased velocity of air causes the soft tissues at the back of the throat to vibrate, creating the snoring noise.

While annoying to others, simple snoring is harmless, it may cause dry mouth or a sore throat but heavy snoring is often a symptom of a serious medical condition called Obstructive Sleep Apnea (OSA). Obstructive Sleep Apnea is frequently associated with hypertension stroke and other cardiopulmonary problems.


What is Sleep Apnea?

"Apnea", a Greek word meaning "absence of breath" remains the most under diagnosed problem in medicine. Snoring is a prime diagnostic indicator of sleep apnea. Apnea refers to the subsequent cessation of breathing during sleep. Sleep apnea earned its name from the fact , in snoring; the breathing actually stops for 10 seconds to a minute or more, this is called an apneic event. An apneic event occurs when the upper airway passage is blocked, or obstructed. This obstruction is due to the relaxation of the muscles surrounding the pharynx during sleep, causing them to collapse. For this reason, it is commonly referred as Obstructive Sleep Apnea, or OSA.

OSA is the most common form of apnea. There are also two other forms of apnea. Central sleep apnea is where the breathing simply stops during sleep and is resumed only when a patient awakens. The severity of central sleep apnea is related to the number of times the patient stops breathing during sleep. Sometimes, central and obstructive sleep apnea can occur together (mixed apnea), but in central sleep apnea there is no obstruction.

Each time the upper airway passage is blocked, oxygen saturation in the bloodstream falls, and the heart must work harder to circulate blood. Blood pressure rises and the heart may beat irregularly or even stop. When the brain senses this decrease in oxygen saturation, the brain partially arouses the sleeper just enough to gasp for air. This arousal is usually not enough to wake the sleeper, but the sleep partner may notice the sleeper choking or gasping for air during sleep.


* Reprinted by permission "How to Stop Snoring in 30 Seconds" by Thomas E. Meade DDS.


Should You Be Concerned?

Ask yourself these questions:

  • Have you been told, or do you awake and find you're choking or gasping for air
    during sleep?
  • Do you feel tired during the day, even though you got a full night's sleep?
  • Do you wake frequently with headaches or a sore throat?
  • Do you have high blood pressure?
  • Do you snore loudly?
  • Is your sleep restless?
  • Does your sleep partner comment that your legs and/or arms suddenly jerk
    during sleep?

If you answered YES to any or all of these questions you should seek further evaluation . You may also want to take a moment to answer a short questionnaire called the "Epworth Sleepiness Scale" (ESS). According to clinical research published in Sleep, The Journal of the American Sleep Disorders Association, ESS has proven to be very accurate in determining whether or not a snorer may also suffer from obstructive sleep apnea.

Use a pencil to write down your answers and total your score!

*Material in this section from: Johns MW. A new method for measuring daytime
sleepiness: the Epworth Sleepiness Scale. "Sleep", 14 (6); 540-545




Treatment of Snoring and Sleep Apnea

Treatments vary tremendously depending upon the severity of the sleep apnea and the prescribing doctor. The best thing you can do is to be knowledgeable about your condition and the options available.

There are four basic types of treatment available: (there are lifestyle changes, appliance therapy, Continuous Positive Airway Pressure (CPAP) and surgery.)



Lifestyle Changes

Simple lifestyle changes can make a significant improvement in your sleep. Some things you can do to help include:

  • Watching your weight
  • Exercising regularly
  • Avoiding alcohol, drugs, and heavy meals before bedtime
Weight is often a major factor in snoring and OSA. The extra mass around the neck can contribute to the collapse of the airway. This is one reason men might snore more than women.

Age is also a factor because as we get older, the muscles in the neck tend to relax not being as firm as when we were younger, adding extra mass to obstruct the airway. We also tend to put on a few extra pounds increasing the ability in obstructing the airway. Shedding those unneeded pounds can make a tremendous difference in the quality of sleep.


Oral Appliances
Mandibular repositioners or oral appliances such as the TheraSnore are an excellent method of treatment for snoring and mild to moderate sleep apnea. The TheraSnore, worn while asleep, gently holds the mandible (lower jaw) in a forward position. This forward position, even if it is only 1 mm, prevents the airway from becoming obstructed. The TheraSnore oral appliance is fit in the doctor's office in as little as 30 minutes without the need of any labs, models or impressions. The day you ask for the TheraSnore is the day you go home with it. Normally it takes four to seven nights to get used to wearing the appliance all night long. Once you begin wearing the appliance all night, you'll be amazed how each morning you will awake feeling refreshed and rested.

The Adjustable TheraSnore oral appliance has an effective rate of 93% in the treatment of mild to moderate sleep apnea as well as simple snoring.


CPAP

Continuous Positive Airway Pressure or CPAP as it is commonly referred to is by far the best mechanical device for treating sleep apnea. Many say CPAP is the gold standard for treating OSA. CPAP has been proven effective for approximately 90 to 95 percent of all OSA sufferers. CPAP is essentially an air compressor that attaches to a mask which is secured over the patient's nose/mouth. The machine uses closely regulated positive air pressure to maintain an open airway. The major drawback to CPAP is many patients cannot tolerate the mask over the face while sleeping.


Surgery


Surgery is usually reserved for those OSA patients who have not responded to medical treatment. New surgical procedures are developed on a regular basis. However, surgery is very invasive and painful. The most common surgical procedure for snoring and sleep apnea has been uvulopalatopharyngoplasty, or UPPP. In UPPP, the surgeon removes loose tissue in the upper airway, including the soft palate and the uvula, using a scalpel.

In recent years, laser surgery, or LAUP, has become a popular treatment for snoring. As you can see from the name, this procedure achieves the same results as the UPPP, but the surgeon uses a laser instead of a scalpel, The laser beam trims the uvula and the soft palate in a series of clinic sessions performed under local anesthesia. Both the UPPP and the LAUP remove tissue which may obstruct the airway.

While surgery enjoys a good initial success rate in some, effectiveness is often diminished over time. Some patients may suffer a change in their voice and regurgitation of liquids through the nose when swallowing or even the loss of the gag reflex.

One of the latest forms of surgery to treat snoring is called Somnoplasty. This procedure involves shrinking the uvula by using a radio-frequency generator connected to a narrow needle. The needle penetrates the uvula and destroys a small area of inner tissue by generating heat of 158 to 176 degrees Fahrenheit. Somnoplasty can be costly and sometimes require more that one treatment. We have only mentioned a few of the various surgeries to treat snoring and sleep apnea. There are many different forms of surgery to treat OSA.

...providing safe sleep since 1987

The Food and Drug Administration (FDA) requires that the TheraSnore® and all other anti-snoring appliances be fit by a physician or dentist. Patients may not fit themselves.

Disclaimer: The information provided by distar.com is not intended to be medical advice. If you suspect you have a sleep disorder you should seek care from a qualified professional. Distar is not responsible for any mistakes or omissions on the distar.com site.