Why Do I Snore?
How to sleep, breath, and live…..BETTER!
By Thomas S. Jennings, DDS, Colorado Springs LIVING WELL Magazine
Is getting an adequate amount of quality sleep an issue in your life or that of a loved one? Have you noticed the presence or increase of these symptoms:
Night Time Choking or Grasping For Breath
Heart Disease and High Blood Pressure
Morning Headaches, Irritability, and Impaired Concentration
Reduced Resistance to Infection
Decreased Sex Drive or Sexual Impotence
Fatigue and Excessive Daytime Sleepiness
Increased Driving and Work-Related Accidents
If so, maybe you are one of millions of American families affected by Obstructive Sleep Apnea, or diminished night time breathing caused by airway obstruction referred to as OSA. What causes OSA? There can be contributing factors, but OSA is primarily caused by a gradual narrowing and eventual total closure of the airway by nature of the tongue falling back into the throat. As this phenomenon occurs with varying severity, the resultant symptoms can range from light snoring (vibration of the closely approximated soft tissue walls of the throat or pharynx) to those of total occlusion of the airway that lasts 10 seconds or more and occurs repeatedly through the night. As the body senses the lack of oxygen and the accumulation of carbon dioxide, defense mechanisms take over and temporary arousal occurs. In addition to the lack of adequate oxygenation, OSA sufferers are significantly affected by the absence of enough restorative sleep as these episodes of arousal can occur hundreds of times each night. Combined these issues acting synergistically produce significant health issues:
Stroke – 40-80% of stroke victims also have OSA
Depression – 40% more likely
Heart Attack – Four times more likely
Death while sleeping – Twice as likely
Motor Vehicle Accident – Seven times more likely
Diabetes – Increased incidence
What can you do to find out for sure if you have Obstructive Sleep Apnea? If you have one or more of the associated symptoms ask your physician or dentist about filling out a simple questionnaire called an Apnea Risk Evaluation Screening Test. If symptoms and questionnaire results warrant further evaluation, you will be referred for an “attended and monitored” overnight sleep study called a Polysomnogram. This test, which takes place at a sleep clinic or hospital, is considered the gold standard in sleep testing. In some cases an “unattended” Home Sleep Test can be used with a device that is dispensed to the patient for use at home, after which the data collected is interpreted by qualified health care providers.
What can be done? There are several treatment options available:
- Continuous Positive Airway Pressure (CPAP) apparatus maintains an open airway with air pressure by way of a pump, hose, and rubber face mask that is held in place with a series of straps. This is the most predictable way of treating OSA. CPAP is effective and has very few negative side effects, but a significant percentage of patients find it uncomfortable or intolerable and seek alternative treatment.
- Surgery can be used to create a more open airway with varying degrees of success. This treatment option can be very invasive, sometimes worsen the problem, and is accompanied with the risks and recovery associated with surgical procedures.
- Because the tongue is connected to the lower jaw (mandible), an intraoral devise can be used to hold the airway opened by maintaining its slightly forward posture, or advancement, relative to the upper jaw. This type of appliance is called a Mandibular Advancement Splint (MAS). As with CPAP some complications can occur with MAS, but it is considered a good alternative to those who have CPAP compliance issues.
Accompanied lifestyle changes are highly recommended in conjunction with CPAP, surgery, or MAS, as they greatly increase the effectiveness of each treatment choice. Those changes include weight loss, over-the-counter nasal steroids and sleep aids, and improved sleep hygiene. Improved sleep habits include:
- Going to sleep and waking up the same time every day.
- Establishing a relaxing bedtime routine such as soaking in a hot bath, reading, or listening to soothing music.
- Ensuring your bedroom is dark, quiet, comfortable and cool.
- Sleeping on a comfortable mattress and pillows.
- Using the bedroom only for sleep and intimacy; no TV.
- Finishing eating at least two to three hours before bedtime.
- Exercising regularly.
- Avoiding caffeine within six to eight hours before bedtime.
- Avoiding nicotine and alcohol close to bedtime as both drugs can lead to poor quality sleep.
If you have any questions concerning snoring, obstructive sleep apnea, and especially the management of these problems with the use of oral appliances, please contact my office at 719-590-7100.