Snoring is often poked fun at, but it’s no laughing matter. Around 90 million Americans experience snoring nightly. For half of those people, snoring may be a sign of a dangerous sleep disorder called Obstructive Sleep Apnea (OSA). Obstructive sleep apnea always causes loud snoring, but loud snoring isn’t always a sign of obstructive sleep apnea. Snoring in the absence of OSA is referred to as primary snoring. Snoring due to OSA is bad news by any measure.
What causes snoring?
Snoring is caused when the tissues in the back of the throat relax to an extreme degree. These tissues slide partially into the airway, where they vibrate when air passes across them. The severity of a person’s snoring is affected by their build, weight and many other factors.
How is snoring due to sleep apnea different?
In Obstructive Sleep Apnea, a person’s breathing slows or even stops. “Apnea” itself refers to a temporary halt in breathing. The brain senses a sharp, rapid rise in carbon dioxide and rouses the sleeper briefly, so briefly that there’s no memory of the sleep interruption. Sleep returns immediately upon the resumption of normal breathing. This pattern occurs over and over during the night, from a few times to hundreds of instances. Unlike primary snoring, sleep apnea is caused by a fundamental failure of a primary life sustaining function—in this case, breathing.
Snoring in OSA sounds different from primary snoring. Snoring in OSA is very loud, followed by silence due to the airway being choked off by the back of the tongue and tissues in the lower oral cavity. Next, loud gasping and choking noises following, sometimes accompanied by snorting or half-formed vocalizations.
Sleep quality with OSA is abysmal. OSA causes the release of stress hormones that put immense pressure on the heart and major blood vessels. OSA contributes to high blood pressure, daytime tiredness, chronic fatigue, and even depression. People with OSA tend to gain weight, which makes their situation even worse. OSA leads to metabolic syndrome, in which nutrients aren’t efficiently processed or absorbed by the body. Work performance suffers because of OSA and interpersonal relationships suffer. OSA also may lead to congestive heart failure, atrial fibrillation, heart attack, and stroke. The above disorders are all primary risks of OSA.
Sometimes OSA causes breathing to stop for more than a minute. Lack of fresh oxygen injures organs and tissues on a microscopic but cumulative level. The brain uses almost one-quarter of the freshly oxygenated blood in the body at any given time. A drop in oxygen impairs brain function, causing impairments in memory, mental clarity, and retention of information.
There are more concerns. Lack of consistent, restful, regenerative sleep leads to a marked drop in concentration and coordination, which can cause accidents. People may nod off in episodes of micro-sleep
How is primary snoring treated? What about OSA?
Primary snoring can be treated by over-the-counter nasal strips and sleeping in different positions. Reducing alcohol intake sometimes relieves primary snoring. In cases of OSA, several options are available. In the case of an obese patient, weight loss can relieve pressure on throat tissue. Large tonsils and adenoidal tissues can be removed to open up air passages. The CPAP (continuous positive airway pressure) device is the most common and best treatment. CPAP uses a small air blower, which forces a steady stream of air onto the face of the wearer via tubing and a mask. Although CPAP treatment is effective, sleeping with a CPAP machine is challenging. Many people find it awkward and uncomfortable.
There are newer devices on the market that use different technology to alleviate sleep apnea, such as the Expiratory Positive Airway Pressure device (EPAP). Provent, an EPAP system, uses nasal plugs with tiny valves that partially close during exhalation, generating pressure in the airway that keeps it from closing. Provent requires no masks, no electricity and is portable. Provent requires a prescription.
Mouthpieces are also available that treat OSA. They help your throat to stay open by gently moving your jaw forward, which in some cases is enough to relieve obstructive sleep apnea. If you want to try this
approach, you’ll be referred to a dentist who specializes in sleep medicine to be custom-fitted for a mouthguard.
EPAP and primary snoring
The FDA has approved the Theravent snore therapy system for use as an over-the-counter primary snoring treatment. Theravent devices fit over the nostril, creating positive pressure that keeps the airway open when exhaling.
Get help for OSA
No one should dismiss snoring as an unavoidable annoyance. There’s at least a fifty percent chance a snorer has obstructive sleep apnea. A physician can make an accurate diagnosis, most often through a sleep study. There’s no reason to give up on getting the best sleep of your life. With diagnosis and treatment, all the harm from OSA can be prevented.
Consult our professionals at Lifetime Dental Health if you are a snorer, and we can discuss possible next steps to get you the sleep you deserve!