By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

October 7, 2009

LOUD SNORING COULD SIGNAL SLEEP APNEA

Question:  I think my husband may have sleep apnea. He snores really loudly. He is a bit overweight and has mild high blood pressure. I can’t get him to go to the doctor because he thinks he is fine. Can you give me some information so I can decide how bad he really is? 

Answer:  When a person stops breathing briefly during his or her sleep, the condition is called sleep apnea. This disruption to breathing usually lasts for less than 30 seconds and is not, typically, life-threatening. The sleeping person usually is not aware that he or she has a problem.

Obstructive sleep apnea (OSA) is the most common type of sleep apnea. It occurs when the throat muscles relax and close off the airway. Loud snoring is often the most prominent symptom in OSA, although not everyone with OSA snores. Other symptoms include daytime sleepiness, or awakening with a dry mouth or throat. Often, a spouse or partner observes lapses in breathing.

OSA is most common in overweight, older people, and those who have high blood pressure, diabetes or a family history of the condition. Men are more likely than women to develop OSA, and smokers and people who use alcohol are also at a greater risk.

Symptoms of OSA can include waking up with a dry mouth or sore throat, waking up abruptly during the night -- possibly with shortness of breath -- and excessive daytime sleepiness. Many people with OSA don’t feel rested when they get up in the morning, and this chronic fatigue can, in turn, lead to depression and memory problems. OSA can also increase the likelihood of complications with surgery and anesthesia. 

If your husband has a combination of these risk factors and symptoms, he should see his family physician. Once OSA is diagnosed, the primary medical treatment is weight loss. A recent study has shown that a loss of about twenty-five pounds in most people cured their OSA. It may also be advisable for your husband to change sleep positions. Sleeping on one’s side often improves snoring, and avoiding alcohol or sedative medications close to bedtime also can reduce OSA symptoms.

If the doctor feels it’s advisable, he or she may refer your husband to a sleep specialist for additional tests. Or if your husband has an anatomical problem of the airway, he may be referred to an ear, nose and throat specialist. 
There are surgical treatments for anatomical problems causing OSA. Most people with severe OSA use a positive pressure breathing machine at night. This keeps the airways open and decreases both the snoring and the OSA.
You should continue to encourage your husband to seek medical advice. If his snoring is keeping you awake, too, it’s worth seeking medical help.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, Communication Office, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only.  It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.