Have you ever wondered why you or your spouse snore? Is snoring really harmless or is it a more sinister sign of underlying sleep-related breathing problems? Sometimes, it may just be due to you suffering from nasal congestion during a bad cold but it could also be due to airway obstruction in a condition known as Obstructive Sleep Apnea (OSA).
In Obstructive Sleep Apnea, snoring may be associated with breathing difficulties, which may present with gasping, choking and grunting noises, disrupting your sleep. The repeated pattern of sleep disruption means persistent poor sleep quality which in turn leads to daytime fatigue and tiredness. Sometimes, this poor sleep quality can be a trigger for headaches, memory loss and a general feeling of lethargy and malaise. Snoring noises are caused by the nasal and throat airways closing off during sleep, when airway muscles start to relax in deep sleep mode. Structural factors such as enlarged tonsils and long uvula (the “dangly” tissue at the back of your throat in the middle) further crowd the airway, as will large floppy tongue tissue which will fall backward to close off your airway during sleep. When the airflow entering your airway is disturbed or turbulent, this often leads to persistent vibration of the uvula, contributing to the snoring noises. The reduced airflow means the amount of oxygen carried to your vital organs such as the heart and brain, is decreased.
If Obstructive Sleep Apnea remains undiagnosed and untreated, there is a significant risk of going on to develop heart disease, suffering heart attacks and strokes, irregular heart rhythms (arrhythmias) which can lead to sudden death, high blood pressure and poor blood sugar control. Did you know that if you suffer from obstructive sleep apnea, having OSA may worsen the control of other existing health conditions, such as lung disease and diabetes? Behavioural and mental health issues may also occur due to poor sleep quality from sleep apnea (OSA). Eventually, all these factors may act together to create a higher risk of developing cognitive issues such as dementia, at an earlier age compared to people who do not suffer from obstructive sleep apnea.
If you happen to have a blocked congested nose at the same time, perhaps due to sinus infections or nasal allergies, then your snoring is more likely to worsen and become even louder. Many people do not realise that having a blocked nose and not being able to breathe clearly through your nose is NOT NORMAL! These patients have suffered from blocked nose problems for such a long time that they have long forgotten what it is like to be able to breathe clearly through their nasal passages. When you have to breathe constantly through your mouth, you will tend to suffer from dry mouth and sore throat problems.
So what are the causes of a blocked nose? Crooked nasal bones and cartilage inside your nose may narrow your nasal passages to reduce airflow into your nose: This is called a Deviated Nasal Septum. Inferior turbinates are sausage-shaped soft tissue structures inside your nose which can enlarge to further narrow your nasal passages, usually related to inflammation caused by nasal allergy or infection.
However, the nose alone is not usually the only factor to cause persistent loud snoring. More worrying signs of airway obstruction when you sleep include other types of noisy breathing noises such as repeated gasping, grunting, choking and recurrent waking episodes at night. Daytime tiredness, recurrent headaches in the morning and poor general health with memory loss may also arise from poor sleep quality caused by Obstructive Sleep Apnea (OSA). Studies show that in the longterm, overall poor performance at work and school may become affected as a good night’s sleep is the key to maintaining good physical and mental health.
So snoring is often the main sign of partial airway obstruction when you are asleep and this may be linked to underlying obstructive sleep apnea.
Here are 5 Helpful Tips by Dr Annabelle of The ENT Clinic on what to do if you suffer from snoring and other worrying signs of OSA:
- You probably need a sleep study to investigate if you do have OSA: This is suaully undertaken in the comfort of your home as an overnight study, wearing a special watch-like tracker device to monitor oxygen levels, breathing patterns, sleep stages, heart rate and positional changes.
- You could try a nasal spray and a course of decongestant medication to see if this might help reduce your snoring: If it helps, then it means that your snoring is caused mostly by nasal congestion or a blocked nose.
- You need to have a Nasoendoscopy: A simple check of your nose, throat and airway with a small camera in clinic is done by your friendly ENT specialist.
- You should consider lifestyle changes as factors such as weight gain, smoking and regular alcohol intake will worsen your snoring.
- A trial of CPAP (Continuous Positive Airway Pressure) treatment may be useful to help you decide between surgery vs using CPAP every night to treat your Obstructive Sleep Apnea. Your friendly ENT specialist can usually help arrange this for you.
Breathe well, sleep well, live well!