Sleep Disordered Breathing

Overview

Obstructive sleep apnea (OSA) is a treatable disorder in which a person stops breathing many times during the night. OSA is associated with serious health problems and a diminished quality of life. Snoring is a strong indication that OSA may be present.

Sleep and Breathing

During normal breathing, air passes through the nose and the flexible structures in the back of the throat, such as the soft palate, uvula and tongue. While you are awake, the muscles in these structures hold the airway open. Normally, when you fall asleep, these muscles relax but still hold the airway open, and healthy sleep can occur without disruption.

Sleep-disordered breathing is a term which indicates that breathing is affected due to the sleeping process itself where the throat muscles collapse and prevent adequate breathing. This, in turn, disrupts sleep creating a condition where both sleep and breathing are dangerously affected. Snoring and obstructive sleep apnea are both considered sleep-disordered breathing events.

Snoring

Snoring is the sound of obstructed breathing during sleep. Sometimes snoring can be harmless, but generally it is a danger sign that indicates a serious problem which progresses from upper airway resistance syndrome (UARS) to OSA.

Snoring occurs when the structures in the throat are large and the muscles relax enough during sleep to cause the airway to narrow and partially obstruct the flow of air. As air tries to pass through the partially collapsed airway, the throat structures vibrate causing the sound we know as snoring. Large tonsils, a long soft palate and uvula, certain jaw formations and excess fat deposits contribute to the collapsibility of the airway.

Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea occurs when the airway completely collapses during sleep and airflow stops entirely. Since no air can be drawn into the lungs, the oxygen level in the blood drops which eventually signals the brain to partially awaken in order to stimulate the throat muscles to open and clear the obstruction. This usually happens with a loud gasp or choking sensation. Once the airway is open, breathing and sleep can resume. However, the relaxing influence of sleep affects the throat muscles as before and this process starts again and continues over and over all night. People with OSA experience disrupted sleep and periodic drops in oxygen levels each night. This is associated with cardiovascular disease and excessive daytime sleepiness. The condition known as upper airway resistance syndrome (UARS) lies midway between snoring and true OSA. People who suffer from UARS suffer many of the symptoms of OSA but do not really have OSA.

Especially for The Bedpartner

Second Hand Snoring

At the very least, snoring is an obnoxious irritation! In addition, loud, continuous snoring can have significant health consequences for the bed-partner.

Studies show that when snoring is treated, the bed-partner’s sleep quality is improved leading to better health.

Other studies demonstrate that the bed-partner’s mood, daytime alertness, quality of life and personal relationship with the snorer is improved when the snoring is resolved.

Research in 2003 showed that the bed-partners of snorers may experience noise-induced hearing loss over time.

Treatment Options

Sleep-disordered breathing (snoring and obstructive sleep apnea) can be managed in several ways:

Behavior Modification

Modification of certain behaviors can help reduce the tendency of snoring and OSA but generally do not cure it unless it is very mild. These modifications include weight loss, sleeping on your side instead of your back, avoiding alcohol and sedatives before bedtime, and eliminating smoking.

Positive Airway Pressure

Considered the "gold standard", continuous positive airway pressure (CPAP) or bi-level positive airway pressure (Bi-PAP) work very well to manage snoring and OSA in the vast majority of people. It requires the use of an air compressor at bedside to deliver forced air into the nose via a nasal mask which keeps the airway open with air pressure. However, the treatment is intrusive and cumbersome for many people and therefore rejected in a significant number of cases.

Surgery

There are several surgical options to treat snoring and OSA ranging from relatively simple to very invasive and complex. Depending on the severity of the problem and the type of surgery done, the results can vary from person to person. Many times the process can be painful and expensive. However, when it is successful, it can provide a good solution to the problem

Oral Appliance Therapy

Oral appliances have been used since the mid-1980’s to successfully manage snoring and OSA. They are very effective for many people but not everyone. Recent research and official medical practice parameters indicate they are best utilized for mild to moderate conditions and whenever CPAP is not tolerated.

Back to top