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Do you wake up not feeling so refreshed?

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Friday, February 25, 2011

Do you wake up not feeling so refreshed?

Snoring is a huge issue in peoples lives that can cause marital issues, make you the butt of many jokes, and just cause you to have nights of fitful sleep.  The American Association of Oral and Maxillofacial Surgeons estimate that between 30-50% of the US population has problems with snoring, for some people it's a chronic issue and some people it is sporadic and only when they are completely exhausted, but for some it is a real medical concern because it is actually obstructive sleep apnea (OSA) or central sleep apnea (CSA).  I wanted to let you know what the difference is, how you can make some changes on your own to try to alleviate your symptoms, and what your medical options are.

So why do we snore?
During times of complete exhaustion, after drinking alcohol, or if there is swelling in the throat tissues due to GERD (Gastroesophageal Reflux Disease), the muscles in the roof of your mouth relax which allows them to vibrate, obstruct your airway a little, causing you to create a more forceful airflow through the tissues and the vibrations/airflow force cause you to snore!!

What can I do to try and stop?
There are a bunch of things that you can do to try and stop snoring, and they are really pretty simple lifestyle changes:
Lose weight: as little as 10lbs can make a huge difference, the more weight on your neck as you sleep, increases the required force of airflow through the muscles in your mouth
Avoid/limit Alcohol: it can relax your muscles even further in the roof of your mouth and cause you to snore when you normally wouldn't.
Avoid heavy meals two hours before you go to bed: after a heavy meal, your body is focused on digesting the food in your stomach, so everything else tends to have decreased blood flow and muscles relax.
Lay off Sleeping Pills: They create a form of deep sleep and complete relaxation of your muscles, if you have a tendency to snore, you will snore more with use of sleeping pills.

Give these a try and see if your snoring disappears or decreases, most likely then your only issue is snoring, and it isn't more serious....although you should still discuss this problem with your HCP to be safe and make sure that they don't want to do further sleep studies!

How do I know if it is OSA or CSA?
You may have:
- Excessive daytime sleepiness (barely able to keep your eyes open in the afternoon)
- Difficulty staying asleep
- Extremely loud snoring
- Waking up gasping for breath
- Reports from a significant other/seeping partner that you stop breathing
- Morning headaches
- Waking up frequently with a sore throat
**If you have any of these, you need to go see your HCP and tell them about your symptoms.  OSA and CSA need to be treated!

What are the complications from OSA and CSA?
Heart attack, stroke, decreased libido, inability to concentrate, irregular heartbeats, high blood pressure, mood problems (due to lack of sleep), irritability, ruin relationships/marital strain, memory problems, and impotence.

What puts me at risk?
- Being overweight (although thin people can have the disorder too)
- Neck circumference >17" for men and >16" for women
- Smoker
- High blood pressure
- Use of Alcohol/Sleeping Pills
- Narrow throat (you might not know unless you've had surgery before)
- Male
- Family History
- Age >60 years old
-Prolonged sitting (people who primarily sit can have fluid shifts from their legs to the rest of their bodies when they lay down at night to rest)

What are the treatments?
After talking to your HCP, and getting some sleep testing done, you will be officially diagnosed and there are various treatments that will be suggested, usually to try medical treatments first, then surgical.
- Continuous Positive Airway Pressure (CPAP): Basically a little machine that gives sir pressure through your nose into your airway while you sleep and allows you to keep your airway open and not obstruct. It prevents snoring, and while the little contraption looks like it would be really uncomfortable, people who use these machines to treat sleep apnea, say it gives them the best night sleep, and they love it!
-Bilevel Positive Airway Pressure (BPAP): similar to CPAP but gives different pressures during inhalation and exhalation based on what works best for you.
- Oral appliances: there are oral appliances that can pull the tongue and lower jaw forward to keep the soft palate (muscles of the roof of the mouth) tight.

Surgical treatments:
- Uvulopalatopharyngoplasty (UPPP): The tissues from the back  and top of your throat are removed to prevent the vibrations that cause snoring and obstructions.
- Maxillomandibular Advancement: Your jaw is moved forward allowing for more space near the soft palate and makes obstruction less possible.
- Tracheostomy: For SEVERE apnea in which you constantly obstruct at night; a plastic tube is inserted into your neck to allow for free air passage, below the areas that obstruct. You can keep it covered during the day, but open while you sleep to keep your airway open.
- Sometimes nasal polyps can be removed to aid the problem or fix a deviated septum (a curvature in the structure of the nose)

It is estimated that 1 in 5 US adults has some form of sleep apnea, so if you are a snorer please go try to make some changes and talk to your HCP, there is no need to live with the side effects of poor sleep, and while some of the treatments seem pretty extreme, they will keep you living longer, healthier, and happier!!  Plus, your significant others will thank you!! So go get checked out, and talk to your HCP about your options, and get on the road to better sleep and a better life!!

Yours in Good Health


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