Dr. Liu
April 9, 2012
Filed under Health & Wellness

Loud snoring is often considered a funny topic or simply an annoyance. Today, however, we know that snoring should be taken more seriously, as it can be indicative of a life-threatening disorder known as sleep apnea—a chronic condition that occurs when a person repeatedly stops breathing during sleep. There are a variety of causes for sleep apnea, from upper airway obstruction, to a failure of the brain to initiate breathing, and it can be made worse by other medical conditions like heart failure and stroke.

Obstructive sleep apnea (OSA) is just one “flavor” of sleep disordered breathing (SDB) anomalies, and the most common. Others include obesity hypoventilation syndrome (OHS) and central sleep apnea (CSA).

People with OSA may stop breathing for 10-20 seconds or even longer, many times throughout the night. In addition to loud snoring, other symptoms include choking or gasping during sleep, non-restorative sleep, sleepiness during the day, lack of alertness, impaired cognitive functioning, slower reaction times and difficulty in concentrating.

About 12 million American adults suffer from OSA which is typically more common among men—about one out of every 25 middle-aged men versus one out of every 50 women of the same age range. However, the onset of menopause in women increases the risk of developing sleep apnea five-fold. OSA is more common as we get older; about one out of every 10 people over the age of 65 have some form of OSA.

Risk factors include being overweight, having a narrow airway, a thick neck, hypertension, smoking, alcohol intake, use of sedatives and tranquilizers, and a family history of the disease. Ethnic groups, including African-Americans, Hispanics and Pacific Islanders, also are at higher risk of OSA.

Obesity hypoventilation syndrome (also known as “Pickwickian Syndrome”) occurs in severely obese patients who fail to breathe either fast enough or deeply enough. The result is blood that is low in oxygen and high in carbon dioxide, even while awake. Like sleep apnea, OHS patients may stop breathing altogether intermittently during sleep. Obstructive sleep apnea is often in patients who have OHA. If untreated, these condition strain on the heart and can cause heart failure, leg swelling and other symptoms.

Central sleep apnea is a less common form of sleep disordered breathing, but can be associated with a history of heart failure and stroke. In central sleep apnea, the patient makes no effort to breathe during the night, and this is often associated with sleeplessness and recurrent awakenings throughout the night.

Perhaps the biggest challenge in dealing with sleep disordered breathing is simply making people aware of these illnesses and encouraging them to seek out help. According to a Wisconsin sleep cohort study, more than 90 percent of women and 80 percent of men with moderate to severe sleep apnea were undiagnosed. A diagnosis is made based on the patient’s family and medical histories, a physical exam, and oftentimes a sleep study, such as those conducted at Mercy Medical Center’s Sleep Center.


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