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Dr. Michael J. Breus

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Sleep Apnea And The War On Snoring

Posted: 09/20/11 09:07 AM ET

The war against snoring has lately gotten very public.

A major hotel chain is marketing "snore absorption rooms" in some of its locations in Europe and the Middle East: sound-proofed rooms filled anti-snoring beds and pillows. The hotel chain has also inaugurated what it calls "snore patrols." Within designated quiet zones in the hotel, employees monitor the noise from patrons' snoring -- if a guest's snoring reaches a certain noise level, they can expect a knock on their door!

Meanwhile, there's talk of this new celebrity trend: the snoratorium, a soundproof bedroom designed for the snorer-in-residence to sleep in luxury and comfort -- and away from anyone who might be disturbed by their noisy sleep habits. (Celebrity couples aren't the only ones retreating to separate rooms in search of undisturbed sleep. Separate bedrooms are an increasingly common choice for couples.)

I'm all in favor of a war on snoring, but I'd rather see a focus on eliminating snoring as a health problem, rather than finding inventive ways to mask the sound, or sending partners to separate bedrooms. Snoring should never be ignored; it is a sign of disordered sleep and can have serious health consequences -- especially if the snoring is accompanied by Obstructive Sleep Apnea (OSA).

Sleep apnea is a serious sleep disorder that causes your airway to close, cutting off your breathing during sleep. In the case of sleep apnea, this can happen a handful of times during the night. People who suffer from moderate to severe sleep apnea stop breathing many times over during the course of a night's sleep, as frequently as once a minute or more. Sleep apnea of any degree prevents you from getting restful sleep, and can lead to chronic sleep deprivation, which is associated with a litany of serious health problems, including cardiovascular disease, diabetes and obesity.

A new report from the U.S. Health and Human Services Agency for Healthcare Research and Quality focuses on obstructive sleep apnea in adults, it's related health complications and the possible options for treatment. The good news is that there are several effective and safe treatment options for sleep apnea. The bad news is that sleep apnea remains significantly under-diagnosed -- many snorers out there have no idea that they are suffering from this disorder. The National Institutes of Health estimate that 12 million adults have been diagnosed with OSA -- but there are likely millions more who have yet to be diagnosed.

Not everyone who snores has OSA. But snoring is a key symptom of sleep apnea. Other symptoms of sleep apnea include:
• Waking feeling tired and unrefreshed
• Excessive sleepiness during the day
• Morning headaches
• Difficulty with concentration, memory and focus
• Moodiness
• Chronic congestion
• Someone observes your disrupted breathing

If you recognize any of these symptoms, it's time to have a conversation with your doctor about an evaluation for OSA. A diagnosis of sleep apnea always starts with a conversation with your physician. In some cases, the process may also include a stay at a sleep clinic, or sleeping at home with a monitor that measures disruptions to breathing.

If you've been diagnosed with sleep apnea, what comes next? There are a number of treatments for OSA that have proven effective.

• A CPAP, or Continuous positive airway pressure machine, is the most common treatment option for sleep apnea. Sleepers wear a mask which pushes a constant stream of air through the airway, preventing the airway from collapsing and cutting off breathing. CPAP machines have proven to be very effective in treating sleep apnea -- and eliminating the snoring that so often accompanies it. The machine often takes some getting used to for patients, but the rewards --restful sleep, protection against health problems associated with OSA -- are worth it.
• A MAD, or Mandibular advancement device, also called an oral appliance, is a mouthpiece that keeps the jaw in a forward position and the airway open during sleep. An oral appliance is custom fitted by a dentist. There are over-the-counter mouthpieces sold as anti-snoring devices, but these are not the same thing as the oral appliance. You should be sure to speak to your doctor before using an anti-snoring mouth guard.
• There is a fairly new treatment available, called Provent, that uses a small disposable one way valve placed over each nostril that can be used as alternative to CPAP. Provent requires a doctor's prescription.

These treatment options for sleep apnea have been well researched. We know they are safe, and we know they work. There are a surgical options for sleep apnea, which involve the removal of tissue at the back of the throat to widen the airway. It's not yet clear that surgery is as effective as the other treatment choices available, but we know surgery involves more inherent risk.

And let's be sure not to overlook the fact that lifestyle changes -- losing weight, exercising, cutting out alcohol -- may reduce your sleep apnea. They'll also probably improve your overall health.

So let's engage in the war on snoring -- but let's make sure we're attacking the problem in the right way.

Sweet Dreams,
Michael J. Breus, PhD
The Sleep Doctor™
www.thesleepdoctor.com

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