How to know if your snoring is bad or dangerous (and what to do about it)

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Obstructive sleep apnea is a serious sleep disorder in which people stop breathing for 10 seconds or longer at a time.

Snoring can be a leading sign of obstructive sleep apnea—but at some point in our lives, we all snore. A cold or allergy can block the nasal passages, a few drinks too close to bed will automatically relax the muscles of the tongue, palate and throat – and before we know it, we’re unconsciously breathing air past soft tissues. are forced, causing the vibration to emerge as a snore.

“Snoring can be normal and nothing to worry about,” said sleep specialist Rebecca Robbins, an instructor in the division of sleep medicine for Harvard Medical School. “When it becomes a loud, hoarse snore, or stops breathing, that’s where we start to get concerned.”

it is estimated that at least 25 million American adults And 936 million adults between the ages of 30 and 69 worldwide People with obstructive sleep apnea can have it, and many people go undiagnosed.

The condition is called “obstructive” sleep apnea because unlike central sleep apnea—in which the brain sometimes quits telling the body to breathe—obstructive sleep apnea is caused by a blockage of the airway by weak, bulky or relaxed soft tissues. It happens.

“You’re trying to get air in and out with your belly and your chest, but because of a blockage in the upper airway, you can’t. Often you’re not aware of this struggle, but it is for someone watching.” can be very scary for the individual,” sleep expert Dr. Raj Dasgupta, associate Professor of Clinical Medicine at the Keck School of Medicine at the University of Southern California.

If left untreated, obstructive sleep apnea puts you at higher risk for high blood pressure, heart disease, type 2 diabetes or depression, and even premature death. american academy of sleep medicine,

How can you tell when your snoring has become dangerous to your health? Sleep experts use a sleep questionnaire with an easy to follow acronym: STOP BANG.

Snoring is a leading indicator, so there’s no doubt that it leads the list of potential warning signs. But it’s not a quiet soft snore, and certainly not a snore that one might call “cute”.

“We’re talking loud, obnoxious snoring that would drown out conversations or be heard through closed doors,” Dasgupta said. “Some very descriptive bed partners of my patients with obstructive sleep apnea describe their partners’ snoring as a ‘dying bear’ or a scene from ‘Jurassic Park.'”

Robbins said that being really tired during the day is a major indicator of poor sleep. Combined with snoring, this can be a telltale symptom of sleep apnea.

Robbins, co-author of the book, said, “Anytime you have a moment to fall asleep—sitting down for a rest after lunch, at the movie theater—these are all hallmark symptoms along with fatigue and bring the house down with your snoring.” take away.”Sleep to Success! Everything You Need to Know About Sleep But Are Too Tired to Ask,

Many people – if not most – are not aware that they snore at night. Nor do they know they stop breathing during the night, until the blockage is so bad that they wake up gasping and choking.

“The O stands for Observed Apnea, and it’s actually worse than just snoring,” Dasgupta said. “Apnea means no airflow—no air coming in, no air going out. You’re not breathing. Observed apnea is really a red flag.”

Bed partners are often key to the diagnosis of obstructive sleep apnea.

“Seeing your partner stop breathing, snoring, coughing or gasping for air are all signs the snoring may not be normal, and then it’s something that deserves attention from a sleep experts,” Robbins said.

Obstructive sleep apnea can cause high blood pressure. Every time a person stops breathing for a few seconds, the body’s sympathetic nervous system kicks into action and raises blood pressure. In addition, the body releases stress hormones called catecholamines, which can also raise blood pressure over time.

While high blood pressure by itself is not a sign of a sleep disorder, it can be a warning sign when combined with other signs. Fortunately, treatments for obstructive sleep apnea, such as continuous positive airway pressure, or CPAP, have been shown not only to help sleep apnea—they also lower blood pressure.

What is your body mass index? This is the score most commonly used to indicate the level of weight. to measure bmiHealth professionals use height and weight data to track changes in weight relative to height. If your BMI falls between 18.5 and 24.9, then your weight is considered normal. You are considered overweight when your BMI is between 25 and 29.9 — and a BMI of 30 or higher indicates you are obese.

People who are obese or severely obese (with a BMI of 35 and above) often have obstructive sleep apnea because excess weight in the mouth, tongue, and neck causes the soft tissues in them to collapse, making it easier to breathe without snoring. It becomes difficult to take.

“Losing weight may be a big part of what a health care provider recommends for addressing sleep apnea,” Robbins said.

Obstructive sleep apnea is on the rise worldwide as obesity reaches epidemic proportions, but it was not seen frequently before the 1970s, he said.

As we age, the muscles in our soft palate and neck, including those in our neck, lose tone. So being over the age of 50 is another possible sign that your snoring may or may not be obstructive sleep apnea.

There is some good news: studies It has been observed that sleep apnea is mild to moderate in the elderly, with more severe cases occurring in younger age groups.

Having a large neck circumference, either due to being overweight or genetic, is a leading indicator of possible obstructive sleep apnea.

“Now you don’t want to be weird and start building up on your loved one’s neck at night,” Dasgupta said. “The rule of thumb is always going to be a collar size over 17 inches (43 cm) for a man, and over 16 inches (40.6 cm) for a woman will put you at higher risk for sleep apnea.”

are you male? Then unfortunately, that also puts you at increased risk of obstructive sleep apnea. some reason Maybe men have thicker tongues and more upper body fat, especially in the neck, than women. Men also tend to have more “belly fat,” which can make it harder to breathe normally.

“however, We certainly see a lot more obstructive sleep apnea in women after menopause,” Dasgupta said.

Now is the time to score your risk.

Give yourself one point for every “yes” answer to these questions: Do you snore? Are you tired during the day? Does your partner notice you snoring? Do you have high blood pressure? Are you overweight? are you big Is your neck circumference large? are you male?

If you scored between 5 and 8, you are at high risk of having obstructive sleep apnea and should be evaluated by a sleep specialist.

“Sleep tests nowadays are much easier than in years past, when you could just go to a sleep lab,” Dasgupta said. “You don’t have to be stuck in a lab with all these wires looking like Frankenstein. You can do the sleep test at home in your own bed, which is nice.

But don’t ignore your symptoms, as negative health effects shouldn’t be ignored american academy of sleep medicine: “Like a fire alarm, snoring is a warning of danger that demands your attention.”

If your score is between 0 and 2, your risk is clearly low, so snoring isn’t a major concern for your health. Dasgupta said a score of 3 to 4 puts you at intermediate risk, but that doesn’t mean you should ignore your symptoms, especially if you share your bed with your loved one.

“It’s always good to be a good person, and if it affects your bed partner, I think it’s worthwhile to evaluate,” he said. “If your bed partner is woken up several times during the night by your snoring or is unable to sleep because of your snoring, then that bed partner is going to be sleep deprived, and that is not good for their health. So it’s not always about you.

The treatment of choice for sleep apnea is the use of continuous positive airway pressure, or CPAP. By inflating air into the lungs through a nasal mask, the device helps keep the airway unobstructed throughout the night.

Losing weight can significantly reduce—or even eliminate—obstructive sleep apnea, as loss of tissue mass in the mouth, tongue, and neck reduces pressure on the airway. Doctors may also prescribe an oral appliance designed to widen the airway by moving the tongue or jaw forward.

Surgery may be recommended if structural issues such as nasal polyps, enlarged tonsils or adenoids, or a deviated septum are contributing to the apnea.

Mild cases of sleep apnea may respond to “positional therapy,” a fancy way of saying that placing the sleeper on their side instead of their back during sleep, which can improve airway flow and reduce snoring. Can do.

“I’m a big fan of simple, at-home solutions, like sewing tennis balls onto the back of pajamas so people don’t rub their backs,” Dasgupta said.

“You can get even more creative by having someone put their bra upside down and then put tennis balls into the cups,” suggests Robbins.

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