Sleep Apnea
Snoring Is Nothing to Snicker About!
Do you snore? Does your bed partner snore? Or, does another family member snore (son, daughter, a child, parent, etc.)? Snoring can be one of the more noticeable and audible signals of Obstructive Sleep Apnea. Nearly 54 million adults in the U.S. have obstructive sleep apnea (OSA), a chronic condition that occurs when your muscles relax during sleep, allowing soft tissue to collapse and block the airway. This can cause you to stop breathing hundreds of times per night for anywhere from a few seconds to more than a minute at a time. These breathing pauses are followed by brief awakenings that disturb your sleep and can result in excessive daytime sleepiness.
It is estimated that about 57% of men, and 40% of women in the United States snore. It is not uncommon for people to ignore this phenomenon; however, snoring could be a huge indicator of OSA. Much like OSA, if you snore, be sure to mention this to your physician.
Snoring is not innocent.
Over half of the population snores. Loud snorers have:
Over half of the population snores. Loud snorers have:
When selecting a treatment option, it is important that you pick an option you will use. When OSA is left untreated, it often causes excessive daytime sleepiness and fatigue, as well as morning headaches and memory loss. Sleep apnea also is a threat to the safety of you and others, as it increases your risk of drowsy driving and workplace accidents. Untreated sleep apnea has been linked to serious health problems such as:
- high blood pressure
- stroke
- heart issues
- blood sugar and metabolism
- cancer
- mental health and alzheimers
- impaired cognitive functioning
- fatigue and accidents
- immune health
The Top Signs of Obstructive Sleep Apnea Include:
- Sexual Dysfunction – Apneic sufferers lack sexual desire due to fatigue; men can even experience ED (erectile dysfunction) due to apnea.
- Headaches – Headaches are frequently associated with OSA due to the lack of proper oxygen levels in the blood, stress to the brain, heart, and other organs due to low oxygen.
- Night Sweats – This can occur due to the increased strain to the muscles of the respiratory system to try to breathe when the throat is blocked.
- Nocturnal Chest Pain – This is due to stress on your heart as it may be dealing with spiking blood pressures due to apnea; cardiac deaths occur in the early morning hours with people who have sleep apnea.
- Bruxism – Grinding of your teeth at night research shows is primarily due to apnea.
- Frequent Urination at Night – Frequent awakenings and desires to urinate can be due to diaphragm and abdomen muscles work harder for breathing and put pressure on your bladder.
- Inability to Focus/Mental Confusion – Lack of proper sleep interferes with neurocognitive function due to poor oxygen levels and fragmentation of our sleep cycle.
- Snoring – Loud episodic snoring often occurs with sleep apnea.
- Interrupted Breathing – Bed partners frequently will notice and become alarmed when you stop breathing.
- Choking or Gasping While Sleeping – During deeper phases of sleep, your muscles become more relaxed including your tongue and your airway can become blocked, your brain activity causes you to awaken out of the deeper sleep to help you catch your breath. This can happen frequently and prevents deep refreshing, rejuvenating sleep.
- Excessive Tiredness – This can lead to social and employment issues.
- Lack of Feeling Refreshed Upon Waking in the Morning – Without deep sleep, you often feel like you didn’t get enough rest
- Dry Mouth, Sore Throat, Sour Mouth or Heartburn – Sleep apnea patients usually are mouth breathers and many have stomach acid regurgitation (GERD) due to the increased effort placed on the diaphragm to breathe.
- Mood Swings/Depression – When you are tired, you are not at your best and even normal daily functions can be overwhelming and stressful.
Sleep Apnea Information & Services
Obstructive Sleep Apnea (OSA) is a medical condition in which a person stops breathing repeatedly during sleep. Breathing stops because the person’s airway collapses and prevents air from getting into the lungs. Sleep patterns are disrupted, fragmented, and results in excessive sleepiness or fatigue during the day.
OSA commonly occurs later in life – after 35 years of age, more often in men and overweight individuals. However, anyone can have OSA, including women, children, and even toddlers!
What Causes the Airway to Collapse During Sleep?
Extra tissue in the back of the airway or throat, such as large tonsils or adenoids, a decrease in the tone of the muscles holding the airway open, and the tongue falling back and closing off the airway can all contribute to the airway collapsing. Ninety percent of people with OSA have not been medically diagnosed. Usually, it is the bed partner who notices the signs of sleep apnea.
Contact our office today, schedule an appointment for a courtesy consultation, and look forward to your best sleep ever!
Are you at Risk for Sleep Apnea?
Not all snorers have OSA but virtually everyone with OSA snores. In order to engage in a productive discussion with your doctor, complete the following questionnaire and discuss the results with him.
Please ask your bed partner to help you answer as accurately as possible. Answer all of the questions below.
| 1. Have you noticed or has your bed partner witnessed any episodes of gasping or choking during your sleep? | Yes / No |
| 2. Has your bed partner witnessed you stop breathing? | Yes / No |
| 3. Do you prefer to sleep sitting upright? | Yes / No |
| 4. Do you wake frequently to use the bathroom? | Yes / No |
| 5. Do you snore when you sleep on your side? | Yes / No |
| 6. Do you snore in all sleep positions? | Yes / No |
| 7. Have you had a recent increase in weight? | Yes / No |
| 8. What is your height? | _______ft/in _______m |
| 9. What is your weight? | _______lb _________kg |
| 10. What is your neck circumference? | Collar Size: _______in _______cm |
It may be hard to determine if your child has a sleep disorder, but there are some questions that can be helpful to assess whether a problem exists. These can be remembered with the simple acronym “BEARS” and can help to identify any sleep disorders that may be present.
B is for Bedtime Problems
There may be many problems that only exist around bedtime. If your child insists that he or she is not sleepy, it may be a fight to get them into bed. They may need a regular bedtime routine or have issues related to behavioral insomnia. This is often the time that parental boundaries become tested and separation anxiety may become evident.
E is for Excessive Daytime Sleepiness
Children require more sleep than adults and often take naps during the day. However, children who are sleeping enough at night should not require naps after they transition to school. Falling asleep in quiet situations, difficulty with concentration or attention, or even hyperactivity may suggest excessive sleepiness. This could be due to insufficient sleep or an underlying sleep disorder.
A is for Awakenings During the Night
The number of times a child awakens during sleep will vary, and tends to decrease as the child ages. Infants will wake often and may require frequent consolation. Toddlers and preschool-aged children should be able to self-soothe and fall back to sleep. Older children should be able to sleep through the night without wakening. If awakenings do occur, the nature of these events should be clarified. Is it due to a night mare or night terror? Does bedwetting occur? Is the sleep environment the problem? Understanding the frequency and what triggers the awakenings can be helpful.
R is for Regularity and Duration of Sleep
As with adults, it is important to keep a regular sleep schedule as part of the basic guidelines for better sleep. This helps to reinforce the natural circadian rhythms of our bodies. If you are uncertain about your child’s sleep, a sleep diary may help to document your child’s sleep patterns. It will also clarify if they are getting adequate rest. Sleep deprivation is a common cause of sleepiness in children and is something that is easily remedied.
S is for Snoring
Children should not chronically snore. If their airway becomes crowded with enlarged tonsils or adenoids, or as a result of obesity, it may lead to the vibration of snoring. Unfortunately, an obstructed airway may also cause sleep apnea. This can have serious consequences, including effects on growth, so children who frequently snore should be brought to their doctor for further evaluation.
Source: Mindell, JA et al. “A clinical guide to pediatric sleep: diagnosis and management of sleep problems.” Philadelphia: Lippincott Williams & Wilkins, 2003.
Category 1
1. Do you snore?
a. Yes
b. No
c. I do not know
2. Your snoring is:
a. slightly louder than breathing
b. as loud as talking
c. louder than talking
d. very loud – can be heard in adjacent rooms
3. How often do you snore?
a. Nearly every day
b. 3-4 times per week
c. 1-2 times per week
d. 1-2 times per month
e. Nearly never
4. Has your snoring ever bothered other people?
a. Yes
b. No
c. I do not know
5. Has anyone noticed that you quit breathing during your sleep?
a. Nearly every day
b. 3-4 times per week
c. 1-2 times per week
d. 1-2 times per month
e. Nearly never
Category 2
6. How often do you feel tired or fatigued after you sleep?
a. Nearly every day
b. 3-4 times per week
c. 1-2 times per week
d. 1-2 times per month
e. Nearly never
7. During your waking time, do you feel tired, fatigued, or not up to par?
a. Nearly every day
b. 3-4 times per week
c. 1-2 times per week
d. 1-2 times per month
e. Nearly never
8. Have you ever nodded off or fallen asleep while driving a vehicle?
a. Yes
b. No
if yes to #8: 9. How often does this occur?
a. Nearly every day
b. 3-4 times per week
c. 1-2 times per week
d. 1-2 times per month
e. Nearly never
Category 3
10. Do you have high blood pressure?
a. Yes
b. No
c. I do not know
Scoring
The questionnaire consists of three categories related to the risk of having sleep apnea. Potential patients can be classified into “High Risk” or “Low Risk” based on their responses to the individual items and their overall scores in the symptom categories.
Categories and scoring:
Category 1: items – 1, 2, 3, 4, & 5.
#1: if ‘Yes’ is the response, assign 1 point
#2: if ‘c’ or ‘d’ is the response, assign 1 point
#3: if ‘a’ or ‘b’ is the response, assign 1 point
#4: if ‘a’ is the response, assign 1 point
#5: if ‘a’ or ‘b’ is the response, assign 2 points
Add points. Category 1 is positive if the total score is 2 or more.
Category 2: items – 6, 7, & 8, (item #9 should be noted separately).
#6: if ‘a’ or ‘b’ is the response, assign 1 point
#7: if ‘a’ or ‘b’ is the response, assign 1 point
#8: if ‘a’ is the response, assign 1 point
Add points. Category 2 is positive if the total score is 2 or more points.
Category 3 is positive if the answer to #10 is ‘Yes’ OR if the Body Mass Index (BMI) of the patient is greater than 30 (BMI must be calculated.)
BMI = (weight x 703) / (height x height)
*Weight in pounds, height in inches OR weight in kilograms, height in meters.
The Epworth Sleepiness Scale (ESS) measures your general level of sleepiness. Your score can help you start a conversation with your doctor about excessive sleepiness (ES) and underlying causes of ES such as obstructive sleep apnea (OSA), shift work disorder (SWD), and narcolepsy.
Rate the chance that you would doze off during the following eight routine daytime situations:
| 0 = Would never doze | 1 = Slight chance of dozing | 2 = Moderate chance of dozing | 3 = High chance of dozing |
|---|
Sitting and reading __________
Watching TV __________
Sitting, inactive in a public place (e.g. a theatre or a meeting) __________
As a passenger in a car for an hour without a break __________
Lying down to rest in the afternoon when circumstances permit __________
Sitting and talking to someone __________
Sitting quietly after a lunch without alcohol __________
In a car, while stopped for a few minutes in the traffic __________
Total (sum above scores) __________
Score:
0-10 Normal Range
10-12 Borderline
12-24 Abnormal
