Heavy snorers are a ticking time bomb
Sleep apnoea is linked to a number of life-threatening illnesses, but there is help at hand.
Published 05/08/2014 | 02:30
We tend to think of snoring as one of life's everyday irritants, on a par with noisy neighbours or a kettle that won't switch off when boiled. In fact, snoring can indicate seriously underlying health issues, which, if left untreated, may jeopardise our well-being and, in severe cases, our life.
Research has shown snoring is bad for us in many ways. It can impact on our sex lives (by impairing the libido) and is known to lead to a greater risk of birth complications among pregnant woman.
Needless to say the chances of a good night's sleep are far lower too. Most serious of all, snoring is linked to sleep apnoea, a condition whereby the sufferer stops breathing in their sleep multiple times during the night.
Obviously this reduces the quality of the individual's repose so that, following a 'good' night's rest, they may be left feeling lethargic and sleep-deprived.
More ominously, it is associated with heart disease and other life-threatening conditions - studies have shown those with this sleep disorder have a 40pc higher chance of dying at a relatively young age.
"Ninety per cent of snorers are 'simple snorers'," says Professor Yves Kamami, a leading global expert in the condition, based at the Fitzwilliam Private Clinic in Dublin.
"However, if you don't treat the snorers after a few years, it starts to become sleep apnoea syndrome. The patient stops breathing during the night - there is an obstruction at the back of the throat and nose.
"Because of the obstruction, there is a lack of oxygen going to the brain. So the patient is suffering from apoxia [oxygen deficiency in the blood]. This can lead to strokes and other major things."
There is more than one kind of sleep apnoea. The most common are obstructive sleep apnoea (OSA) and central sleep apnoea (CSO). In the first - the more regularly occurring of the two - the airway is blocked, typically by the soft tissue at the back of the throat after it has collapsed during sleep (if you stop breathing 10 or more times in an hour, a person is categorized as suffering obstructive sleep apnoea).
In the latter, the airway remains clear. However, problems in the part of the brain controlling respiration have resulted in a failure to signal the breathing muscles.
Anyone can suffer apnoea, including children. That said, men over 40 are at highest risk, especially if overweight, have large tonsils, a large tongue, small jaw bone or a large neck (a circumference of 17 inches or above for men, 16 inches for women).
"When someone has a snoring problem, usually after a few years it leads to sleep apnoea syndrome," says Prof Kamami.
"The patient stops breathing during the night due to an obstruction at the back of the throat and the nose. Because of the obstruction there is a lack of oxygen in the brain. Someone who has sleep apnoea or snoring does not have a restful night's sleep. They may suffer tiredness in the morning. With each passing year an ever greater number of ailments are linked to apnoea," he says.
"Glaucoma of the eyes is caused by sleep apnoea," says Prof Kamami. "We have diabetes caused by sleep apnoea. Year after year we are seeing that sleep apnoea syndrome is causing many more diseases."
The risk of developing the condition increases with age he says.
"Men start to snore at about 40, women at about 50. The main reason is lack of hormones in the blood. As the levels of hormones decrease, the aging of the body is quicker.
"That leads to obstruction at the back of the throat because the uvula in the soft palate [a fleshy extension of the palate] is longer and thicker than before."
Sleep apnoea is treatable in a number of ways. Sometimes the sufferer merely needs to change their lifestyle. It is recommended they give up alcohol after 6pm as this can make it more difficult for the throat to stay open in sleep. Losing weight can help too.
The most common treatment is a continuous positive airway pressure device (CPAP), which blows air into the nose to prevent the airway from collapsing during sleep. CPAP devices look like oxygen masks and, while usually effective, can take a little getting used to.
One method pioneered by Kamami is laser assisted uvulopalatoplasty (LAUP), whereby the uvula is removed. Lasers are also used to reduce the 'turbinates' in the nose, three bones that protrude into the nasal passageway and warm and moisten the air as we breath.
Typically, sleep apnoea involves three distinct blockages, says Prof Kamami. "One blockage is the nose, the second is the soft palate. The third is the tongue. When we have all three...the laser can only treat the nose blockage and the soft palate.
"With the nose, we cure the blockage for about 10 years. For the soft palate obstruction we cure it for life. We cannot use a laser on the tongue. In some cases, if the person loses weight [it can help]. The weight of the tongue is related to the weight of the body - if you gain five kilograms in your body you gain five grams in your tongue. Fitness is an issue. You first need to lose weight. That reduces the size of the tongue."
When treated, the improvement in lifestyle is immense, says Prof Kamami. "Someone with sleep apnoea does not have a restful night sleep. They suffer tiredness in the morning. [After treatment] they will feel refreshed. They will have a deeper sleep - they will feel a big improvement in their quality of life."
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