Do you snore? Read this.
Is your bedroom a symphony? You snore; your spouse snores; Noodles, your pug, snores. Noodles, with a short snout, was bred for a disorder called obstructive sleep apnea (OSA). But when should you worry about your snoring?
OSA afflicts about 1 in 4 people. It’s pervasive, and its symptoms can be evasive. Most people with OSA are not diagnosed.
So how does this sleep disorder “obstruct”? When we sleep, we go from light to deep sleep. Our muscles become relaxed, at times temporarily paralyzed.
Here’s the problem: In some, the muscles around the throat collapse and block the airway – we either completely or almost completely stop breathing. The drop in oxygen occurs in seconds. To regain muscle control, the brain will snap us out of deep sleep into a lighter one. This whole back-and-forth thing happens backstage; we aren’t awake.
In severe OSA, this process occurs at least 30 times an hour. Can you imagine the stress on our body? The fragmented sleep causes excessive sleepiness. The stress from intermittent low oxygen increases risks of heart diseases, strokes, diabetes, etc.
Because we aren’t awake for all this drama, I'm alarmed if I hear, “No matter how much I sleep, I wake up tired.” Indeed, that complaint alone – with or without snoring – deserves further workup. Only half of the people with OSA report a history of snoring.
Other signs to look for: Waking up choking or gasping for air – or better yet, being told that you stop breathing – are highly indicative of OSA. Also if your blood pressure is hard to control, or you fall asleep in church or while driving. Or you have frequent morning headaches that resolve in hours.
OSA is associated with frequent nighttime urination and acid reflux. I’m not saying if you frequent the bathroom at night, you have OSA. But if you’re chronically tired despite “good sleep” and have some of the symptoms, I’d book an earlier doctor’s appointment.
Testing is easy and affordable now. We used to go to a sleep lab where we were hooked up like a sci-fi experiment (Medicare Fee Schedule: $650). My patients often complained, “I don’t think I slept.” I assured them, “You probably did OK because I got a result, and you got a bill.”
Now sleep studies can be done easily at home for a fraction of the cost ($94 to $165). They’re better at detecting moderate to severe cases (80%) than mild cases (40% to 93%). I trust them.
OSA-related physical problems (sleepiness, falling asleep at the wheel, etc.) respond well to treatment. First thing you do: sleep on your side. That might take care of some mild cases. Next: exercise and lose weight (if needed). There’s not a threshold of how much you must do. Any exercise and modest weight loss help. For severe cases, devices (forcing air in or nerve stimulation) and/or surgery may work.
Change in sleep reflects maturity. I go to sleep early, wake up early. I can’t remember the last time I stayed up for New Year’s Eve. Wild romantic dreams are overrated. In dreams, I work on my tax before April (never happened in real life) and I finish. It is what it is.