Learn How To Stop Snoring Without Surgery Blog

Dangers Of Sleep Apnea

Studies show that because sleep apnea causes the oxygen in the blood to drop and it taxes the heart, it can lead to other health problems such as high blood pressure, moodiness, heart attack, stroke, diabetes, depression, decreased interest in sex, memory loss and even eye disease.

In children, sleep apnea has been linked to poor school performance, behavioral problems and even high blood pressure.

Because people with sleep apnea continually get inadequate or fragmented sleep (they wake up to gasp for air whether they know it or not), their driving is inevitably impaired. The resulting daytime sleepiness significantly cuts driving response time down — sometimes ending in fatal automobile crashes.

Experts say it’s one thing for people to ignore their own health, but a tragedy to ignore others.

“If you’re driving next to someone (and cause an accident), you take out more than just yourself,” Downey said.

Several Solutions

In people with sleep apnea, the most common solution is positive airway pressure delivered through a mask worn over the nose (and sometimes the mouth, too). There are three levels: continuous (CPAP), Bi-level (BiPAP) and auto-adjusting (APAP). The most commonly used is the CPAP. Each machine gently flows air into the back of the throat to keep the air passage from collapsing.

“The feeling is the same as if you’re driving in your car with your head out the window going about 20 miles per hour,” Reyna said. “It might take some getting used to, but people feel so much better with the machine because they’re sleeping better.”

According to Nicholson, CPAP machines work about 85 percent to 90 percent of the time.

“The biggest issue with it is not whether it works. It almost always does,” he said. “It’s working with patients to make sure they’re comfortable and compliant with it.”

Lapis said she refused to wear her CPAP machine when she got it. She said it wasn’t romantic and it bothered her.

A CPAP vendor told her at AWAKE (a sleep support group at PVHMC that meets the third Monday of every month from 6 to 9 p.m.) that if she didn’t wear it, she would die.

“The first time I wore it, I called the hospital the next day and I told them I feel like a brand new person,” said Lapis, who has also dropped 100 pounds and 12 dress sizes (to a size .

Some people with sleep apnea have trouble with their CPAP machines. (For CPAP troubleshooting, visit www.sleepapnea.org.

Dan Perry of Chino Hills has had a terrible time trying to solve his snoring problem. Not only did he have his tonsils and uvula removed, but the surgery caused some other problems.

“It didn’t work. In fact, it made it worse,” said his wife Tami Perry, 42, a nurse at Chino Valley Medical Center. “And sometimes, when he eats, he chokes on his food.”

Perry was fitted with a CPAP machine and he wears it, but his wife said he snores around it.

“CPAP doesn’t work for everybody,” Downey said. “It’s really important to have a doctor who recognizes that one size doesn’t fit all on the CPAP machine.”

He used the example of buying a pair of pants.

“If you took home a pair of pants from the store and they didn’t fit, you’d take them back and try to find a different pair, right?” he said. “Somehow people have this misunderstanding that one size fits all with CPAP and that’s not true.”

Doctors work with a lot with different mask sizes, mask types, machines and air delivery systems.

“So, the idea out there is that one unit fits all and we’re way beyond that,” he said.

People who are using CPAP machines that aren’t working properly should go back to their doctors to make sure their masks are fitted right, they’re using the right machine or they have the right mask.

Positive airway pressure is the usual treatment for sleep apnea, but sometimes an oral device that pushes the lower jaw forward, creating a larger airway passage, can help. Losing weight is a big must for sleep apnea.

“A big reason for the increase in sleep apnea is the number of individuals considered obese or overweight,” Reyna said.

(info by La Rue Novick from http://www.dailybulletin.com/Stories/0,1413,203~24505~2969459,00.html)

Imagine a foghorn blasting, a chainsaw buzzing, a diesel truck downshifting on a slanted grade or a garbage disposal gurgling.

Some dear souls must live with sounds like these every night as they fitfully sleep beside snoring spouses.

While some snorers nonchalantly dismiss concerns, jests and punches about the cacophony of sounds they make each night, they might want to take heed. Snoring is a symptom. And for some, the real problem is obstructive sleep apnea (commonly referred to as sleep apnea).

According to the National Sleep Foundation, 90 million Americans snore, 37 million habitually. And of those, 12 to 18 million and possibly many more have sleep apnea.

“Awareness is growing about sleep apnea, but a lot go undiagnosed,” said Dr. Ralph Downey, director of the sleep disorder center at Loma Linda University Medical Center.

Confessions Of A Snorer

Yolayne Lapis slept many years in other rooms because her husband kept her awake at night with his loud snoring. After their divorce (for reasons other than snoring), Lapis learned she was snoring, too.

Before she found out, she said she’d been feeling physically rotten. She was tired all the time. She was overweight. And, she’d wake up with grinding headaches every morning.

Lapis underwent a sleep study at Pomona Valley Hospital Medical Center and discovered she was not only snoring, but she had sleep apnea.

“I was probably as close as possible to death as one can be,” the 57-year-old Claremont woman said. “And I was putting a major tax on my heart.”

People who snore typically have what doctors call primary or simple snoring, or, like Lapis, they have sleep apnea. It’s important to know which one. Sleep experts suggest concerned individuals — especially those whose snoring is associated with obesity, daytime sleepiness or pauses in breathing — undergo a sleep study.

Know The Difference

Primary snoring is caused by the vibrating of tissue in the back of the throat as it narrows and partially blocks airflow.

“The way to think about it is the party favor that you blow and the paper rolls out and flaps at the end,” said Dr. Robert Reyna, a sleep specialist at Kaiser Permanente Medical Center, Fontana. “The narrowing creates a greater pressure and so the air going past it tends to pull on it enough to cause the fluttering of tissue.”

Primary snoring generally doesn’t cause severe health problems but recent studies have shown loud snoring could be linked to high blood pressure and heart disease, according to the American Academy of Sleep Medicine. And that’s not even mentioning all the unhappy spouses who have to sleep next to their snoring counterparts.

“I’ve had many situations where couples have divorced over their partner’s snoring problem,” Nicholson said. “I’ve had them move out of rooms and wear ear plugs.”

People with sleep apnea don’t just snore, they often gasp for air. Apnea literally means “without breath.” The muscles in the back of the throat relax and aren’t able to keep the throat open, despite efforts to breathe. Gravity pulls the tongue back and all that extra tissue blocks the airway, causing pauses in breathing, or apneas, that can last at least 10 seconds per episode. In severe cases, a person can experience up to 60 episodes in one hour.

One doctor explained it like this:

“Imagine somebody is putting a pillow over your mouth and nose and trying to suffocate you and they do this hundreds of times a night,” Downey said. “We would call the police on somebody who was doing that to us. Sleep apnea is the same except our bodies are doing that to us. To not act on that is to ignore the dangers of it.”

(info by La Rue Novick from http://www.dailybulletin.com/Stories/0,1413,203~24505~2969459,00.html)

Children with frequent loud snoring, learning problems, or excessive daytime sleepiness are more likely to have sleep-disordered breathing (SDB), according to a study published in the July 15 issue of the Journal of Clinical Sleep Medicine.

Results of the study show those children who either display frequent, loud snoring or who have a parental report of learning problems are three times more likely to have SDB, while children with excessive daytime sleepiness (EDS) are twice as likely to have sleep-disordered breathing. This association is even stronger when habitual snoring is present along with either EDS or learning problems.

Behavioral and neurocognitive abnormalities occur more commonly in children with SDB than in those without it, according to background information in the article. Many children with SDB, a classification that includes obstructive sleep apnea, report to their physicians that they snore. Substantial research has not previously been presented, however, to define clear pediatric standards of clinical signs and symptoms of SDB.

James L. Goodwin, Ph.D., of the University of Arizona College of Medicine, and colleagues, set out to determine the usefulness of measures that could be easily obtained during an outpatient clinical visit as predictors of SDB in elementary school children.

“In this study, we have provided evidence from a general population of…Hispanic and Caucasian elementary school children about risk factors for SDB to enhance decision making in the clinic on whether or not to refer a child for polysomnography,” the authors write.

The study also shows that boys are slightly more likely than girls to have SDB, and both sleepwalking and sleep talking are associated with SDB in children. Results further indicate, however, that neither obesity nor an estimation of airway size is a predictive pediatric factor.

The Tucson Children’s Assessment of Sleep Apnea (TuCASA) study involved 480 children between the ages of six and 11 years who underwent one night of unattended home polysomnography. The study group was 42.3 percent Hispanic and consisted of an equal number of boys and girls. Other data were drawn from a neurocognitive assessment and a pediatric sleep habits questionnaire that was completed by a parent.

—

Contact: Kathleen McCann of American Academy of Sleep Medicine, 708-492-0930 or kmccann@aasmnet.org

The Journal of Clinical Sleep Medicine is an official publication of the American Academy of Sleep Medicine.
http://www.usnewswire.com/

Researchers from Sydney’s Woolcock Institute of Medical Research are searching for a drug to combat sleep apnea, a condition affecting up to five percent of Australians.

Obstructive sleep apnea interrupts sleep, causing daytime sleepiness and difficulty remembering. Current treatments include an uncomfortable breathing device called a CPAP, which is strapped to the patient’s face, dental devices or surgery.

“Currently we find many sufferers are reticent to sleep attached to a machine [like the CPAP],” says Associate Professor Ron Grunstein, head of the Sleep and Circadian Research Group at the Woolcock Institute.

“Not only does CPAP restrict their movement during sleep, but it can also be a source of frustration for partners who share their bed.”

The institute is seeking 142 people in four trial centres across Sydney who suffer from obstructive sleep apnea and meet a range of other criteria to take part in their trial.

Dr Grunstein says identifying a drug to treat obstructive sleep apnea would transform the way the condition was treated in Australia.

“We believe the identification of a safe drug to treat the condition would see a lot more sufferers coming forward for treatment and a subsequent improvement in their health.”

(info from http://news.ninemsn.com.au/article.aspx?id=54504)

Question: My friend tells everyone that her husband snores so loudly, she has to sleep in another room. Can you help her and him?

Answer: When air rushes into the nose and throat, any redundant or lax tissues there vibrate like a reed in a clarinet — but the sound produced is not the soft, relaxing music of the night.

An answer to the problem can lie in something as simple as weight loss, if that is indicated. Alcohol relaxes throat muscles and throat tissues and leads to snoring, so an alcohol ban should be enforced after dinner. Smoking irritates throat tissues and causes them to swell, another remedial cause of snoring.

Sleeping on the side opens the throat and diminishes snoring. Your friend can sew a tennis ball into the back of her husband’s pajama top to keep him on his side during the night. If he wears a soft neck collar, the kind used for neck strains and found in many drugstores, it lifts the chin upward and keeps the throat tissues from sagging. Oral appliances can do the same job. Dentists can obtain them for your friend, as can ear, nose and throat doctors.

If snoring is disruptive and is not solved by the above measures, a number of procedures can pare away excess throat tissue and quiet the nighttime noise. Some of those procedures involve using a laser.

Snoring is not a joke and is not to be taken lightly. It can be a sign of a serious problem — sleep apnea. In that condition, snoring grows louder and louder until there is a silent pause of 10 or more seconds. The pause comes about because the snorer stops breathing — apnea. These no-breathing spells can happen hundreds of times during the night and have a profound effect on health. A sign of sleep apnea is chronic daytime drowsiness. Sleep apnea can also have adverse effects on blood pressure and the heart. Have your friend observe her husband for apnea spells while he’s sleeping.

(info from http://sun.yumasun.com/artman/publish/articles/story_17484.php)

A clinical trial is under way to see if millions of snorers could sing themselves to a good night’s sleep.

A Royal Devon and Exeter Hospital ear and throat specialist is examining a course devised by local singing teacher Alise Ojay.

They believe singing exercises designed to strengthen the throat could help snoring, as well as a condition known as obstructive sleep apnoea (OSA).

It is thought OSA may contribute to road accidents and hypertension.

Consultant otolaryngologist Malcolm Hilton is leading the trial to establish whether the conditions can be reduced or eradicated.

“Snoring might not be life threatening, but it can be enormously disruptive to people’s lives”
- Malcolm Hilton, otolaryngologist

Weak muscles in the soft palate and upper throat can be a cause of snoring and OSA - and serious singers use singing exercises to strengthen these muscles.

A limited pilot study done by Exeter based singing teacher Alise Ojay in 1999, with the support of the University of Exeter, suggested the exercises could help snorers.

As a result of that trial she designed the Singing for Snorers course.

Mr Hilton is now testing the idea with a controlled clinical trial with 60 patients who are chronic snorers, and 60 patients with mild to moderate sleep apnoea.

Half of each group will actively sing the exercises for three months and half will have no intervention.

Throat muscles

Mr Hilton said: “Millions of people are affected by snoring and OSA.

“Snoring might not be life threatening, but it can be enormously disruptive to people’s lives and snorers often seek medical help.

“OSA can be much more serious, causing people to stop breathing during deep sleep.”

Ms Ojay said: “My Singing for Snorers programme targets the particular muscles of the throat that are implicated in snoring and OSA, and gives them a real workout.”

Researchers are still looking for volunteers who will need to be referred by their GP.

The trial is expected to last about two years.

(info from http://news.bbc.co.uk/go/pr/fr/-/2/hi/uk_news/england/devon/4633787.stm)

Getting enough sleep, adopting good sleep habits, and seeking medical attention for issues such as habitual snoring, daytime sleepiness and the breathing interruptions of sleep apnea can have a huge impact on the life of a child or adult.’ Children who snore are far more likely to have attention and hyperactivity problems than their non-snoring peers, University of Michigan researchers reported several years ago.

Now, follow-up data from some of the same children who took part in that study gives those findings a new, long-term dimension. The latest results are published in the journal Sleep.

Children in the original study who snored regularly were about four times more likely than those who did not to have developed new hyperactivity by the time the U-M team contacted their families four years later. In other words, snoring early in life predicted new or worsened behavior problems four years later.

Similar behavior was seen among children who had had other symptoms of obstructive sleep apnea, in which repeated pauses in breathing disrupt sleep and can reduce blood oxygen levels. For example, children with daytime sleepiness in the original study also were more likely to have developed hyperactivity four years later.

Large Body of Evidence

The findings held true even after the researchers took into account which children already had been identified as hyperactive during the first study, and which ones were taking prescription behavior medicines during the follow-up survey.

In fact, inattention and hyperactivity at follow-up usually were predicted better by snoring and other sleep-apnea symptoms four years earlier than by those same symptoms at follow-up, notes lead author and U-M sleep researcher Ronald D. Chervin, M.D., M.S.

Dr. Chervin and other sleep and breathing researchers have built up a large body of evidence on this issue in recent years. The sleep-behavior link rests on the concept that snoring, sleep apnea and other breathing problems during sleep diminish the quality of sleep, repeatedly reduce oxygen levels, and affect daytime behavior.

One group of boys under the age of 8 who had the worst sleep-breathing problems during the first study were approximately nine times more likely to have developed new hyperactivity four years later than were boys of the same age who had not had such sleep problems.

The results are from a prospective study of 229 children who are now between the ages of 6 and 17. The children were drawn from the group of 866 2- to 13-year-olds whose parents originally were surveyed in the late 1990s in the waiting rooms of several community-based pediatrics clinics.

The parents agreed to allow the researchers to mail them a follow-up survey four years later; 229 returned it. The follow-up group was statistically comparable to the initial group.

Support for Causal Relationship

Both at the baseline and at follow-up, the parents completed standardized questionnaires that measure a child’s behavior and sleep characteristics. Children were encouraged to help their parents complete the questionnaires.

The initial study, published in March 2002 in the journal Pediatrics, found that kids who snored regularly were twice as likely as non-snorers to have hyperactivity or attention issues at the same time. Among boys under the age of 8, the rate was four times.

“To our knowledge, this new study is the first long-term, prospective research to show that regular snoring and other clues to the possible presence of sleep apnea predict future development of inattention and hyperactivity,” says Dr. Chervin, who serves as director of the U-M Health System’s Michael S. Aldrich Sleep Disorders Laboratory and associate professor of neurology at the U-M Medical School.

“These findings strengthen the hypothesis that untreated sleep-breathing problems in childhood can contribute to the development of hyperactivity,” he added.

Definitive Proof Elusive

Data from small groups of children who received treatment for their sleep-breathing problems — usually by removal of the tonsils and adenoids — have indicated that behavior may improve as sleep improves. Larger studies of pre- and post-treatment sleep and behavior patterns are now underway; Dr. Chervin and his colleagues currently are analyzing data from one performed at U-M.

But definitive proof that breathing problems during sleep affect daytime behavior is still elusive, the U-M authors write. And a long-term randomized controlled trial, the gold standard of medical research, might never be done because it would require researchers to withhold treatment that has become an accepted standard of care.

The new paper is the first to show that sleep problems come before hyperactive behavior, and that one predicts the other — which may help bolster the sleep-behavior theory.

“In research, a prospective study that follows a group over time and assesses them at two or more time points carries more weight than one that looks for risk factors and possible outcomes all at the same time,” says Dr. Chervin. “That’s what we set out to achieve, and we believe we’ve shown a clear predictive link.”

Quality of Sleep and Behavior Attributes

The study combined two different validated survey instruments: one that asked parents about their children’s behavior patterns, and one asking about snoring, sleepiness and characteristics that may indicate sleep-disordered breathing problems.

The sleep portion of the survey asked about frequency and severity of snoring, as well as the tendency to struggle to breathe or stop breathing temporarily during the night, to breathe through the mouth during the day, to wake up feeling unrefreshed, or to have a hard time waking up.

All these can mean a child has sleep-disordered breathing, which can affect the quality of sleep. Scores for snoring frequency and severity, and for sleepiness and sleep-disordered breathing, were tallied for each child to allow each tendency to be considered on its own.

The behavior portion of the survey asked about attention to tasks and schoolwork, distraction, forgetfulness, fidgeting, inappropriate action and excessive talking, as well as other symptoms of attention-deficit/hyperactivity disorder. The children were assigned scores based on the total number of attributes their parents said applied to them, and how often.

Sleep Problems Often Undiagnosed

Dr. Chervin and his colleagues say that a further prospective study is needed to confirm their results and compensate for some of their study’s limitations. The research focused on a mild to moderate level of hyperactivity, and it’s not certain whether the findings would apply to children with full Attention Deficit/Hyperactivity Disorder.

The authors also note that more precise measures of sleep-breathing problems, and of sleep quality, might reveal even more.

Until such studies can be done, Dr. Chervin says, parents should pay attention to their children’s sleep — and their own.

“Sleep problems in both children and adults are often undiagnosed, even though they can have a major impact on health, behavior and quality of life,” he says.

“Getting enough sleep, adopting good sleep habits, and seeking medical attention for issues such as habitual snoring, daytime sleepiness and the breathing interruptions of sleep apnea can have a huge impact on the life of a child or adult,” Dr. Chervin notes.

(info by Lisa Olen from http://health.dailynewscentral.com/content/view/0001189/51/)

Experts have known that children who snore may be far more likely to have problems with attention and hyperactivity than kids who don’t.

Now, new research from the University of Michigan suggests the link is even stronger than many thought.

“The association is pretty strong, and we are saying it may be causal,” said Dr. Ronald D. Chervin, director of the university’s Sleep Disorders Center. “The sleep disruption itself may lead to hyperactivity.”

Chervin and his colleagues from both the University of Michigan and the University of Washington evaluated 229 children, who were aged 6 to 17 at the time of the study. They were drawn from a group of 866 2- to 13-year-olds whose parents were surveyed originally in the late 1990s in the waiting rooms of pediatric clinics. The parents of 229 children returned the follow-up survey four years later.

Of the 229, 30 children were rated as hyperactive. And that hyperactivity was predicted by the habitual or loud snoring, sleepiness or sleep-disordered breathing in the original survey done four years before, the researchers found.

Snoring and other sleep problems, Chervin and his colleagues concluded, “are strong risk factors for future emergence or exacerbation of hyperactive behavior.”

The new study, Chervin said, is the first long-term look at the association. Children in the original study who snored regularly were about four times as likely to have developed new hyperactivity by the time the survey was done four years later. Snoring early in their lives predicted the children’s new or worsened behavior problems four years later.

Exactly how the snoring may lead to the hyperactivity is not clear.

“One of the reasons could be the oxygen levels during the night are lowered repeatedly, every time the throat closes,” Chervin said. At least in animal studies, he said, lowered oxygen brings about behavior changes.

Or, the sleep disruption may lead directly to the hyperactivity, Chervin added.

Adults who are sleep-deprived just look very sleepy, he said. “Kids may stay awake at any cost, including creating an environment that helps them stay awake at any cost,” he added

On the survey, parents were asked how often and how severely their child snored, and if the child had a tendency to struggle to breathe or stop breathing temporarily during the night, or had a hard time waking up. They were also asked about their child’s behavior during the day, and whether there were attention problems.

Another expert, Dr. Ann Halbower, medical director of the Pediatric Sleep Disorders Program at Johns Hopkins University Children’s Center, said the new research makes the long-suspected link between snoring and hyperactivity “sound much more causal.”

“It still isn’t proof,” she said. But the new research at least is strongly suggestive of a cause-and-effect between snoring and hyperactivity, she said.

However, as Halbower pointed out, there could be yet another explanation, such as an underlying problem that leads to both the snoring and the hyperactivity.

Until more is known, Chervin said, he urges parents to take their children’s sleep problems seriously and to describe them to the child’s pediatrician.

The most common treatment to stop the snoring is removal of the tonsils and the nearby adenoids, he said.

Halbower agreed that parents should be alert to chiildren’s sleeping problems. “Parents should be aware that snoring is not a good thing,” she said. It has been linked to poor school performance and other problems.

Another sleep study, reported in the June 30 issue of Neuroscience found that getting a good night’s sleep triggers brain changes that help improve memory.

Researchers at Beth Israel Deaconess Medical Center, in Boston, evaluated 12 healthy college students who performed a sequence of skilled finger movements similar to playing a piano, doing the exercise after a 12-hour period of wake or sleep while researchers performed MRI scans.

The cerebellum, one of the brain’s motor centers controlling speed and accuracy, was more active after sleep, and the limbic system, which controls for stress and other emotions, was less active.

The students performed better after the sleep period.

(info by Kathleen Doheny from http://www.forbes.com/lifestyle/health/feeds/hscout/2005/07/01/hscout526625.html)

An estimated 18 million people suffer sleep apnea, although many have never been diagnosed. Millions more cope with restless legs syndrome, insomnia or narcolepsy, marked by excessive daytime sleepiness even after a good night’s sleep.

Fifty years ago, the field of sleep medicine didn’t exist.

But today, as scientists gain greater understanding of the intricacies of sleep and develop better treatments, more people are seeking help for problems that can have serious medical consequences.

The death last year of football player Reggie White from complications possibly related to sleep apnea heightened awareness.

“It’s not just the snoring and holding of breath, but there are lots of medical issues associated with sleep apnea — high blood pressure, diabetes, heart attacks, strokes and on rare occasions, sudden death,” said Dr. Frederick Nachtwey, who directs the Sleep Disorders Center at Doctors Medical Center Pinole.

Many experts predict that as the nation copes with obesity, apnea will continue to rise. Studies show that people who are overweight are at greater risk for the condition.

(info from http://www.indystar.com/apps/pbcs.dll/article?AID=/20050617/LIVING01/506170310)