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Sleep Apnea & Snoring

What is snoring?

Most people think of snoring as nothing more than a nuisance to roommates or bed partners. Loud and persistent snoring, however, can signal a serious health problem. Snoring occurs when the soft tissue structures of the upper airway collapse onto themselves and vibrate against each other as we attempt to move air through them. This produces the sound we know as snoring. Large tonsils, a long soft palate, a large tongue, the uvula, and excess fat deposits in the throat all contribute to airway narrowing and snoring. Usually, the more narrow the airway space, the louder or more habitual the snoring.

 

Snoring could be a symptom of Sleep Disordered Breathing.

 

Definition

The term Sleep Disordered Breathing describes a range of sleep breathing disorders that include: snoring, upper airway resistance syndrome and obstructive sleep apnea. Sleep Disordered Breathing is a continuum of these conditions. Simple snoring represents the mildest disorder that is noticed when breathing during sleep is very loud due to the near collapse of the upper airway. When the snoring becomes worse, due to further airway collapse, more effort is required for breathing and sleep becomes interrupted. This condition is referred to as upper airway resistance syndrome. The most dangerous problem in the continuum is sleep apnea. Sleep apnea describes the condition when oxygen levels in the blood drop as a result of the complete collapse of the airway. During an apnea, breathing cannot occur, and the sleeper is forced to awaken to resume normal breathing.

Sleep Apnea

Obstructive Sleep Apnea occurs when the tongue and soft palate collapse onto the back of the throat. This blocks the upper airway, causing air flow to stop, which in turn causes the blood oxygen level to drop. When the blood oxygen levels drop low enough, the brain moves out of deep sleep and the individual partially awakens (an arousal). The airway finally reopens, usually with a loud gasp. The individual then moves back towards deep sleep until the next apnea occurs. This cycle of events may occur many times during the night, sometimes once per minute.

The combination of low oxygen levels and fragmented sleep are the major contributors to most of the ill effects that the sleep apnea patient suffers. In addition to excessive daytime sleepiness, studies show that sleep apnea patients are much more likely to suffer from heart problems (heart attack, congestive heart failure, hypertension, high blood pressure), strokes, metabolic syndrome, weight gain, diabetes, mood swings, acid reflux, and sexual dysfunction as well as having a higher incidence of work related and driving related accidents. The diagnosis of sleep apnea is graded mild, moderate, or severe.

Risk factors include:

  • Snoring

  • Weight gain

  • Getting older

  • Family history

  • Malformation of the orofacial area (misaligned teeth, jaw, palate)

  • Bruxism (teeth grinding)

  • Polycystic Ovarian Syndrome (PCOS)

  • Menopause

  • Progesterone/Estrogen deficiency

  • Anatomy and physiology of the airway

  • Small Jaw, Thick Neck (greater than 17″ males, 16″ females)

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