If your spouse punches you on a nightly basis because you snore, you may be just a habitual snorer or you could be one of 18 million American adults who suffer from sleep apnea.
According to the National Sleep Foundation, chronic snoring is a strong indicator of sleep apnea and should be evaluated by a physician. Dr. Gerald Dey, a pulmonary and sleep medicine specialist with Medical Center East, said mild snoring often can be helped by weight loss, elevating the head and staying off your back. "Sometimes stopping mild snoring is as easy as treating nasal congestion," he said. "Anything that narrows the airway causes reverberation of air."
Dey added that ear, nose and throat specialists can treat mild snoring with outpatient surgical procedures such as radiofrequency and laser ablation to remove or shrink excess tissue in the upper airway. But if the patient has obstructive sleep apnea, these treatments will not be beneficial.
Dr. Robert Doekel, a sleep medicine specialist with the Sleep Disorders Center of Alabama, said the typical sleep apnea patient is a middle-aged, overweight man, although they are seeing more and more sleep apnea sufferers who are not overweight. "These patients usually come to see us because their spouse or sleep partner say they snore," he said. "The patient is usually unaware of the snoring but will say it's not unusual for him or her to feel tired and fatigued upon awakening in the morning."
Often the snoring itself is enough to warrant treatment, but untreated sleep apnea can cause life-threatening problems such as excessive sleepiness during the day which can lead to accidents, high blood pressure and cardiac problems. Extreme cases can lead to a shortened life span, Dey said. As a result, physicians who suspect sleep apnea should refer the patient for a sleep study to confirm the diagnosis.
Henry Miller, director of the newly renovated Medical Center East Sleep Services, said 70 percent of their referrals are men who snore or have extreme fatigue. "We conduct an overnight sleep study during which we record four to seven hours of sleep time," Miller said. "While the patient sleeps, we monitor his EEG, eye movement, respiration, heart rate and oxygen level." Miller said they generally begin to see a reduction in air flow during the first half hour in sleep apnea sufferers. "The oxygen level drops so low, the patient wakes up," he said. "The patient thinks he wakes up about four times a night when, in fact, it can happen 20 to 60 to 120 times depending on the severity."
Dey said the "gold standard" for treating sleep apnea is a continuous positive airway pressure (CPAP) device. "If the patient can tolerate CPAP, it almost universally fixes the problem," he said. Dey added that these machines have been improved greatly over the past few years making them more comfortable and convenient.
While there are surgical treatments available for sleep apnea, Dey cautions against doing surgery before trying CPAP. "Fifty percent of people who have surgery benefit. That means that 50 percent don't benefit," he said. "It's often more difficult to treat if a patient has the surgery first and then goes to CPAP. I recommend my patients try and fail with the CPAP before considering a surgical option."
Regardless what treatment the patient decides on, the most important thing is to make sure you regularly get a good night's sleep, Doekel said. "There's been an increased interest in sleep disorders because health professionals realize how important sleep is to your general health," he said. "It's like a three-legged stool for health – you need proper nutrition, exercise and sleep. If you don't sleep right or enough it can affect everything."
