“Why do I snore loudly and feel tired and irritable even after a full night's sleep?” Answer is - You might have sleep apnea…
We find it unbelievable that we only snore at night and not during the day, but why is that the case? During the day, our muscles of the neck keep the airway wide and help air pass through the nose and throat smoothly. Meanwhile, during sleep, neck muscles loosen and collapse into this airway, narrowing it and causing airflow turbulence. The suction current created by the rapid airflow vibrates and stretches the uvula and soft palate. Due to the negative pressure pulling the tongue back and blocking the airway, this force causes snoring and sleep apnea.
Air from outside transits to the nasopharynx via the nose. Any obstruction in this passage will cause snoring. The deviated nasal septum that blocks the airway is one of the major causes. As patients feel difficulty breathing through the nose, they tend to sleep with their mouths open at night. This causes turbulence of airflow as it bypasses the nose and results in snoring
Similar causes of snoring are Allergic rhinitis and nose block, Sinusitis with nasal polyps, tumors of the nasal cavity
Patients with tonsillar hypertrophy will also experience snoring because of the same phenomenon and here obstruction to airflow is at the level of the oropharynx.
In obese patients,there will be increased neck circumference due to fat deposition, shorter neck, and loose neck muscles. These are contributing factors to increase the turbulence of airflow and snoring
Acidic reflux in the long term causes elongation of the uvula and edema of the mucous membrane of the throat. The movement of the long uvula with breathing will also cause turbulence and snoring
How loud do I snore?
Usually, snoring is reported by your partner/ roommate. There are several ways to assess the loudness of snoring with the help of questionnaires.
What are the treatment options?
A qualified ENT surgeon will evaluate you to assess the causes of snoring. Treatment options aim at creating a smoother airway during sleep. Usually, a holistic approach is needed in terms of lifestyle changes and surgery together is needed for the reduction of snoring
In cases of obstruction at the level of the nose like a deviated septum or allergic rhinitis, or nasal polyps, the treatment aims at clearing the disease and creating a nasal pathway for the smooth conduct of air. Some doctors recommend a balloon sinuplasty procedure to reduce the forces that create vibration, snoring, and sleep apnea. However, balloon sinuplasty is considered ineffective in reducing sleep apnea symptoms. Balloon sinuplasty comes with a higher risk of complications and an extended recovery period.
Today there are procedures to stiffen or soften the soft palate that can reduce snoring and open the airway in the back of our throat. .
Tonsillar hypertrophy causing snoring needs to be addressed with the removal of tonsils. This clears up the oropharynx and along with stiffening of the soft palate will help in reducing snoring.
In some cases, an oral appliance may also be needed to assist in holding the mouth closed and move the jaw slightly forward to shift an oversized tongue away from the back of the throat.
What's beyond snoring? Heard of Obstructive sleep apnea?
In some people, the throat closes so much that not enough air can get through to the lungs, and when this happens, the brain sends an alarm to open the airway. Most often, this is associated with brief arousal from sleep. The brain quickly reactivates the muscles that hold the throat open. Air gets through again, and our brain goes back to sleep. When we experience this disorder, the term given to it is "obstructive sleep apnea."
In this process, the person tends to keep his mouth open to breathe easily. Mouth breathing also dehydrates the tongue, which results in progressive tongue enlargement, increasing the chance of sleep apnea.
Do I have Obstructive sleep Apnoea? Check it out !!
Here are the symptoms of obstructive sleep apnea:
A qualified ENT surgeon will evaluate you to assess the causes of snoring. Treatment options aim at creating a smoother airway during sleep. Usually, a holistic approach is needed in terms of lifestyle changes and surgery together is needed for the reduction of snoring
Excessive daytime sleepiness
Loud snoring
Observed episodes of stopped breathing during sleep
Abrupt awakenings accompanied by gasping or choking
Awakening with a dry mouth or sore throat
Morning headache
Difficulty concentrating during the day
Mood changes, such as depression or irritability
High blood pressure
Decreased libido
Factors that increase the risk of sleep apnea include:
Excess weight. Obesity greatly increases the risk of sleep apnea.
Neck circumference. People with thicker necks might have narrower airways.
A narrowed upper airway.
Shorter jaw
Double chin
Being older.
Family history.
Use of alcohol, sedatives, or tranquilizers.
Smoking.
Nasal congestion/ Nasal block
Medical conditions like diabetes, Parkinson, etc.,
Tonsillar hypertrophy causing snoring needs to be addressed with the removal of tonsils. This clears up the oropharynx and along with stiffening of the soft palate will help in reducing snoring.
In some cases, an oral appliance may also be needed to assist in holding the mouth closed and move the jaw slightly forward to shift an oversized tongue away from the back of the throat.
Lifestyle changes to adapt
If you're overweight, try to lose weight.
Sleep on your side
Raise the head of your bed.
Treat nasal congestion or obstruction
Limit or avoid alcohol and sedatives.
Quit smoking today.
Get enough sleep.
You can visit your doctor if you have, or if your partner observes the following:
Snoring loud enough to disturb your sleep or that of others
Waking up gasping or choking
Pausing in your breathing during sleep
Having excessive daytime drowsiness, which may cause you to fall asleep while working, watching television, or even driving a vehicle
Is treatment for Obstructive sleep apnea necessary?
Obstructive sleep apnea is considered a serious medical condition.
●Daytime fatigue and sleepiness Patients might find it difficult to concentrate and also find themselves falling asleep at work while watching TV or even when driving. This can put them at higher risk of work-related accidents.
●Cardiovascular problems: Many people with obstructive sleep apnea develop high blood pressure, which can increase the risk of heart disease.
●The more severe obstructive sleep apnea, the greater the risk of coronary artery disease, heart attacks, heart failure, and strokes.
●Obstructive sleep apneaincreases the risk of abnormal heart rhythms (arrhythmias), which can lower blood pressure.
●Complications are also seen with medications and surgery. These medications, such as sedatives, narcotic analgesics, and general anesthetics, relax your upper airway and can worsen your obstructive sleep apnea.
●If you have obstructive sleep apnea, having major surgery, especially after being sedated and lying on your back, can worsen breathing problems. People are prone to complications after surgery.
●Before surgery, tell your doctor if you have obstructive sleep apnea or symptoms related to the condition. Your doctor might want you tested before surgery with a sleep study
●Eye problems. Some research has found a connection between obstructive sleep apnea and certain eye conditions, such as glaucoma.
●Sleep-deprived partners. Loud snoring can keep those around you from getting good rest.
●Patients may also complain of memory problems, morning headaches, mood swings or depression, and a need to urinate frequently at night.
●Children and young people may display attention or behavior problems.
●Individuals with obstructive sleep apnea have been found to be at higher risk for developing a severe form of COVID-19 and needing hospital treatment than those who don't have obstructive sleep apnea.
- Dr. Prashanth R Reddy
“E.N.T. health – ENTry for better senses”.
