Thursday, November 12, 2009
Snoring
Sleep is not just resting or taking a break from busy routines - it is essential to physical and emotional health. Adequate sleep may also play a role in helping the body recover from illness and injury. Even occasional sleeping problems can make daily life feel more stressful and less productive.
How serious is snoring?
Snoring does not only keep you awake the whole night, but it can also annoy your spouse and even destroy your happy relationship. Relationships had been terminated and marriages destroyed all because of snoring. Just imagine if you had to use separate bedrooms or even divorce because your spouse can't take it any longer. In addition to posing a strain on relationships, it can also indicate a possibly dangerous and life-threatening disease.
What causes snoring?
The noisy sounds of snoring occur when there is an obstruction to the free flow of air through the passages at the back of the nose and mouth. This area is the collapsible part of the airway. When you breathe in your sleep, the tongue, muscles of the upper throat and the soft palate (roof of the mouth that separates nasal and oral cavities) collide with the uvula. Air is forced through a narrow airway, causing a loud vibration. Snoring may keep you awake the whole night, and the following day you are tired, your performance at work or school is badly affected and you feel as though you could sleep on your desk at work. Although some may hear their own snores when they're half awake, most snorers are often unaware that they snore until they are told of it.
What is sleep apnea?
Sleep apnea is a debilitating sleep and breathing disorder defined as the cessation of breathing for 10 seconds or more (an apnea) at least five times per hour of sleep. During sleep, the body's muscles relax, which can cause excess tissue to collapse into the upper airway (back of the mouth, nose and throat) and block breathing. When breathing is interrupted by an obstruction in the airway, the brain doesn't get enough oxygen. The body reacts by waking enough to start breathing again. These arousals may occur hundreds of times each night but do not fully awaken the patient, who remains unaware of the loud snoring, choking and gasping for air that are typically associated with obstructive sleep apnea. The symptoms include feeling tired in the morning like you didn't get enough rest. The individual may fall asleep during the day and may spend more time in bed than normal. There is chronic daytime exhaustion and long-term cardiovascular stress. After many years with this disorder elevated blood pressure and heart enlargements may occur.
Risk Factors for Sleep Apnea:
Obesity – Fatty cells infiltrate the throat tissue, possibly narrowing the airways.
Snoring may actually be a cause of changes that triggers some cases of sleep apnea, and not a consequence of it.
Family history – Inherited characteristics in the face and neck can cause breathing abnormalities.
Other medical conditions – Individuals with severe heartburn appear to be at higher risk for sleep apnea.
When the muscles of the mouth are too relaxed either from alcohol or drugs the tongue falls backwards and causes obstruction.
Male gender.
Too tight collars may irritate neck tissues.
Old age :
Snoring gets worse with old age.
Blocked nose :
If your nose is blocked at night, this may cause snoring.
Sleeping position :
Lying on your back causes the tongue to fall backwards and block the airway.
Children:
Large tonsils and adenoids can cause severe snoring and sleep apnea.
Symptoms :
Loud snoring
Increased daytime sleep
Personality changes (irritable, depressed)
Hypertension (frequent)
Monitoring your sleep Checking ones sleep in a sleep study lab is often the only way to rule out sleep apnea. A sleep study records how the lungs, heart and other parts of the body function while one is asleep. It is painless, risk free and takes one full night. Videotaping of the sleep is done and a technician watches the monitors all night and makes sure all equipment is working properly. The results of the study will be discussed by your doctor including whether your air passage is blocked and whether you have sleep apnea.
Treatment:
Lifestyle changes:
Sleeping on one’s side instead of on one’s back can reduce sleep apnea
Patients who are overweight should attempt to reduce their weight
Patients should quit smoking
Alcohol should not be consumed within four hours of sleep
Avoid sleeping pills because this puts you into deep sleep when your muscles relax more causing the throat tissues to sag and restrict breathing
Exercise regularly.
Continuous Positive Airflow Pressure (CPAP) involves wearing a mask that supplies a steady stream of air through the nose during sleep. The airflow keeps the nasal passages open sufficiently to prevent sleep apnea.
Surgical Options:
Uvulopalatopharyngoplasty (UPPP) – this procedure removes soft tissue on the back of the throat and palate, thereby increasing the width of the airway at the throat opening. Nasal Surgery – Nasal obstructions such as a deviated septum may play a role in sleep apnea, and can be corrected through appropriate surgical procedures. Surgery in the throat includes removal of the tonsils and adenoids. In some cases of severe sleep apnea an opening in the necks breathing tube (tracheostomy) may be needed.
Posted By :Dr.Kumaresh Krishnamoorthy, Bangalore, India On 26.12.2008 Mail Now Senior Consultant ENT, Apollo Hospitals, Bangalore, India Phone:080-26304351