Snoring and Sleep Apnea : information for patient

Sleep related breathing disorders are less diagnosed but not negligible in population. Snoring and sleep apneas are commonest type of sleep related breathing disorders. 2-5% of world populations suffer from sleep apnea disorders. Prevalence in India of sleep breathing disorders is around-19.5% and OSAHS (obstructive sleep apnea hypoapnea syndrome) is around 7.5% among urban Indian males. However 80-90% of these patients do not present to physician for their problem mostly due to lack of awareness.

Snoring is a sound made in the upper airway when a person sleeps. It normally occurs as one breathes in air during inspiration. It is a sign of partial obstruction of airways. Snoring disturb bed partner’s sleep and may cause dry mouth or an irritated throat when wake up. Snoring is not always associated with disease however pathological snoring is usually associated with sleep apnea syndrome.

Sleep apnea is a disorder of repeated interruption of breathing during sleep. About one-half of people who snore loudly have obstructive sleep apnea (OSA). OSA happens when the tissue in the back of the throat collapses to block the entire airway. It can happen a few times a night or several hundred times per night. People with severe snoring and OSA suffer from repeated awakening at night and excessive sleepiness during the day. The recurrent episodes of awakenings may lead to personality changes such as irritability or depression, morning headaches, a loss of interest in sex, or a decline in mental functioning. It also is linked to high blood pressure, irregular heartbeats, and an increased risk of heart attacks and stroke. Patients with severe, untreated sleep apnea are two to three times more likely to have automobile accidents than the general population. In some high-risk individuals, sleep apnea may even lead to sudden death from respiratory arrest during sleep.

Patients with the typical features of sleep apnea should be referred to a specialized sleep center or specialist that can perform a test called sleep study also known as polysomnography. This test records the patient's brain waves, heartbeat, and breathing during an entire night. If sleep apnea is diagnosed, several treatments are available. The following are treatment options for snoring and sleep apnea:

Weight loss is the initial treatment of patients with sleep apnea. With significant weight loss some patient may relieve from symptoms. Avoiding alcohol, muscle relaxants, and certain medications is also necessary. Some patient has apnea episodes in particular posture. Avoidance of such posture will lead to decrease apnea episodes.

Oral appliances: It keeps the airway open when patient’s snoring does not improve with weight loss or side sleeping. It may also help in some cases of mild to moderate sleep apnea.

Continuous positive airway pressure (CPAP): CPAP is the standard treatment for moderate to severe cases of OSA. It also may be used for mild sleep apnea, but not for simple snoring. It provides a steady stream of air through a mask to keep airway open during sleep.

Surgery: Surgery may be an option if other treatments fail to improve your snoring or sleep apnea. There are many types of nasal, throat and jaw surgeries. They have very limited role in management of sleep apnea.