February 2008
Control sleep apnea
Snoring is the sound of the flap-like uvula and adjacent soft tissues being rattled by air rushing through a narrowed part
of the throat. If the partial air blockage that causes snoring progresses to episodes of complete blockage—a disorder known
as sleep apnea—the problem can be very frightening. The afflicted sleeper generally stops breathing for anywhere from 10 to
90 seconds, sometimes even longer.
Apnea doesn't just leave you drowsy and irritable the next day; studies indicate that apnea episodes may damage the cardiovascular system, perhaps due to the periodic lack of oxygen or to the repeated over-stimulation of the central nervous system. Retrospective studies suggest that people with full-blown sleep-apnea syndrome, complete with daytime drowsiness, may face a doubled risk of hypertension, a tripled risk of coronary heart disease, and a quadrupled risk of stroke.
Start silencing your zzzzs
Consult your doctor about apnea if:
To test for apnea, your physician may refer you to a sleep center, where you'll undergo usually one night of polysomnography-monitoring
of your breathing, heart function, blood-oxygen level, and brain waves during sleep.
If possible, choose a center accredited by the American Academy of Sleep Medicine (www.aasmnet.org). That helps ensure that you receive not only appropriate evaluation but also insurance reimbursement.
In the meantime, the following self-help steps may alleviate mild sleep apnea:
Apnea doesn't just leave you drowsy and irritable the next day; studies indicate that apnea episodes may damage the cardiovascular system, perhaps due to the periodic lack of oxygen or to the repeated over-stimulation of the central nervous system. Retrospective studies suggest that people with full-blown sleep-apnea syndrome, complete with daytime drowsiness, may face a doubled risk of hypertension, a tripled risk of coronary heart disease, and a quadrupled risk of stroke.
Start silencing your zzzzs
Consult your doctor about apnea if:
- You're inexplicably drowsy during the day.
- You’ve been told that you snore loudly.
- You smoke or are overweight, older, or male.
If possible, choose a center accredited by the American Academy of Sleep Medicine (www.aasmnet.org). That helps ensure that you receive not only appropriate evaluation but also insurance reimbursement.
In the meantime, the following self-help steps may alleviate mild sleep apnea:
- Slim down. Fat deposits narrow your airway, making snoring and apnea more likely. According to researchers, losing a significant amount
of weight—say, 10 percent—is enough to get many people sleeping quietly through the night.
For advice, click Lose extra pounds. - Shun drinks and drugs. Avoid alcohol before bedtime, and skip sleeping pills and narcotic painkillers containing codeine, morphine, or oxycodone,
for at least four hours before bedtime. These drugs can make breathing problems worse. So can the impotence drug sildenafil
(Viagra) and, presumably, two related drugs, tadalafil (Cialis) and vardenafil (Levitra).
- Don’t smoke. Smoking can cause airway tissues to swell. For advice, click Quit smoking.
- Sleep on your side. Lying on your back lets your tongue and the nearby soft tissues slip back into the airway. Sewing soft but noticeable objects
such as tennis balls into the rear of your pajamas or laying thick pillows lengthwise down the bed can help you stay off your
back.
- Keep your neck straight. Sleeping with a bent neck narrows the airway.
- Prop yourself up. Try sleeping at a 45-degree angle, using pillows or a recliner.
- Try CPAP or a prescription mouthpiece. If self-help steps don't work, an approach called continuous positive airway pressure (CPAP) generally will. That's a soft
plastic mask linked to a pump that continuously blows air into your nose to keep your throat open. However, the blowing keeps
many people awake, and the air may dry out your nose. Adjusting the pressure or humidifying the room may help. If you can't
tolerate CPAP, try one of the prescription mouthpieces, which tend to be more comfortable but less effective.
- Consider surgery, as a last resort—there’s an operation that removes throat tissue and widens the airway. It poses small risks, though, of
persistent “nasal regurgitation” (leakage of food from the nose when you swallow) and of scarring that further narrows the
airway. Talk to your doctor.
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