Sleep Disorders and Sleep Apnea
Providing answers and treatment for your sleep problems. Our experience shows that most people can significantly improve their quality of sleep and life through a variety of treatment options.
The effects of loud snoring are numerous. Both the intensity and inherent irregularity of the snoring sound produce its annoying effects. A bed partner’s sleep disruption can be substantial, leading to sleep deprivation and serious tension at home. Often a major source of embarrassment for the sleeper, it can disrupt business and vacation travel. The presence of snoring must also be recognized as an important clue to a potentially even more serious medical disorder, the interrupted breathing in sleep known as sleep apnea syndrome.
Specific testing to characterize and quantify the snoring sound itself is usually unnecessary. However, a careful review of a person’s sleep and medical histories is important to try and ensure this doesn’t signal a more serious underlying condition. A third, or more, of those who consistently snore have obstructive sleep apnea. It is impossible for any physician to be able to really tell that a person’s breathing is truly normal while they sleep. The measurement of breathing during sleep is absolutely essential, as these treatments may help or eliminate snoring but there ability to stop apnea in sleep is very unpredictable.
A wide range of treatments are available for snoring once it has been properly evaluated. These include weight reduction, sleep position therapy, decongestants, modification of alcohol intake, modification of medications being taken for other conditions, nasal patency devices, allergy therapy, dietary modification, nasal surgeries, palatal surgeries, special dental devices, specially designed pillows, and prescription medications.
Sleep Apnea Syndrome is a very serious medical disorder usually developing in long-term, loud (though it doesn’t have to be loud) snorers. It consists of repeated spells in which breathing during sleep stops. These episodes are called apneas and are the result of the excessive relaxation and then collapse of the muscles in the back of the mouth.
Sleep apnea is very common with estimates ranging up to 10 to 15% of men and up to half of that many women being effected. It often produces progressive abnormal daytime sleepiness with irresistible sleep episodes and trouble staying alert while driving. High blood pressure, a major increased risk of heart and stroke, memory problems, mood changes, even sexual dysfunction may all develop.
Accuracy of diagnosis is essential for such a serious disorder. This should begin with a discussion with your primary care provider, where available, and then with the sleep medicine specialist. This sleep disorder is evaluated by sleep testing, either by polysomnography in a sleep laboratory or with a home sleep test. For some patients who are in generally good health, with only the primary complaint of a sleep breathing disorder, a home sleep test may be used. This is the only accurate way to confirm the suspicion someone has sleep apnea, measure how often apneas occur, their length, what happens to oxygen levels, how stressed the heart is, how disrupted sleep is, the effects of sleep position, etc.
A wide selection of treatment options are available. The dominant treatment, however, is nasal continuous positive airway pressure (CPAP), or the closely related device nasal bilevel positive airway pressure. It consists of a small nasal mask and flow generator using room air at varying flow rates, the air used creating a cushion or kind of air splint which prevents the throat from collapsing as well as stopping snoring. This is almost always effective, non-invasive, and adjustable so that treatment can be modified should the disorder worsen. It is a well tolerated and accepted treatment used by tens of thousands nightly and is the treatment of choice for those with moderate or severe sleep apnea.
One form of treatment or another is almost always effective. Remember that the first step in treating this disorder is a sleep medicine consultation, followed by polysomnography or with a home sleep test.