Snoring and Sleep Apnea

What causes sleep apnea?

If your snoring is severe and disruptive, it may be a symptom of a serious breathing disorder: obstructive sleep apnea (OSA). According to the American Academy of Sleep Medicine, loud snoring and OSA are both caused by narrowing of the airways during sleep. People with OSA actually stop breathing for seconds at a time during sleep, usually at least five times per hour or hundreds of times per night, in severe cases, which deprives your brain and body of oxygen and wakes you up.

If your snoring problem is disruptive enough to make you search for a cure, you may actually have a mild, moderate or even severe case of OSA, which requires diagnosis and treatment. This is especially important if you live alone; a spouse or partner is likely to demand that you visit a doctor if he or she sees you in distress during the night, but if you sleep on your own, you may be unaware that a larger problem exists.

Often, OSA is caused by a collapse of the tissues in the back of the throat. When you sleep, your upper airway muscles relax, and (if you sleep on your back) your tongue can fall back into your airway. These tissues not only vibrate and cause you to snore, but also cut off your air supply. This stresses your heart and raises your risk of several deadly diseases:

• Heart disease

• Stroke

• Pre-diabetes and diabetes

• High blood pressure

• Depression

So, how can you tell the difference between garden-variety snoring and dangerous sleep apnea? Only a doctor can diagnose that, but here are some questions you can ask yourself to help determine whether you suffer from sleep apnea:

• Do you wake up feeling fatigued or headachy, even after a full night's sleep?

• Are you sleepy during the day -- even accidentally falling asleep sometimes such as while driving?

• Does your partner say you snore loudly or stop breathing during sleep?

• Do you sometimes awaken with a loud choking or gasping sound?

• Does your neck measure 17 inches or more?

• Is your body mass index (BMI) 25 or higher?

• Do you have high blood pressure?

• Do you have a family member with sleep apnea?

To diagnose OSA, your doctor will have you undergo a sleep study, either at home or at a sleep center, where you will sleep with sensors attached to your body that allow a machine to collect information about how you're sleeping.

How to cure sleep apnea

As you might expect, remedies for OSA are significantly more expensive and involved than those for chronic snoring. One of the leading therapies is Continuous Positive Airway Pressure (CPAP); basically, you wear a ventilator during the night that forces air down your trachea. If you can't tolerate this -- and your apnea is mild or moderate -- your doctor may recommend a custom-fitted mouthpiece instead (see best mouthpiece for snoring).

Surgery is usually less effective, but it can be a last resort if CPAP and mouthpieces don't work. The excess throat tissues are trimmed and tightened -- "a type of face-lift for your throat," MayoClinic.com says.

Less painful snoring surgeries are available. These include:

• Laser surgery to remove the uvula and shorten the soft palate (laser-assisted uvulopalatopharyngoplasty, or LAUPPP).

• Radiofrequency tissue ablation (somnoplasty), which uses a radiofrequency signal to shrink the soft palate and uvula.

• Palatal implants (the pillar procedure), which injects braided polyester filaments to stiffen the soft palate.

However, these alternative surgeries aren't usually recommended for sleep apnea because they're new and haven't been proven effective. CPAP remains the gold standard, with a custom-fitted mouthpiece the runner-up choice. However, these remedies are expensive and can be invasive; they're not suggested for mild, "nuisance" snoring.