Here is an interesting fact I found while catching up on reading medical journals. According to a large study on sleep and heart health, Latinos – or their families– report more snoring than any other group including non latino whites, African-Americans, American Indians and Asian Pacific Islanders.
If your family or significant other is reporting that they cannot sleep because of your snoring and you are feeling tired despite sleep, then you need to think about obstructive sleep apnea. Obstructive sleep apnea is a common chronic condition affecting nearly 26 percent of the U.S. population characterized by frequent awakenings caused by snoring and gasping for air along with daytime symptoms related to disrupted sleep such as tiredness and poor concentration. If that sounds like I am describing you, and your significant other is complaining about lack of sleep, then you should know the following.
1. Latinos in the United States are particularly prone to obstructive sleep apnea.
2. Symptoms of sleep apnea include:
* Restless sleep
* Morning headache
* Dry mouth or sore throat
* Waking frequently to urinate
* Awakening un-rested and groggy
* Memory problems
* Difficulty concentrating
* Low energy
* Awakening in the middle of the night with choking, gasping or smothering
* Loud snoring
* Observed episodes where your breathing stops during sleep
3. Sleep apnea occurs because of the mechanics of the muscles that control the throat, which are used when you are awake for speaking, swallowing, or chewing. You are not swallowing or talking during your sleep and this will cause the throat to naturally narrow, as these muscles are not active. However, in some, this narrowing during sleep leads to blocked airflow, hence the term “obstructive sleep.” Apnea is basically the medical term for lack of airflow (i.e. not breathing).
Insufficient breathing causes the oxygen levels to fall and because the airway is blocked, this requires the person to breath faster and harder to help improve oxygen level until the airway is reopened. The person is almost suffocating and it forces the person to awaken in order to activate the other muscles for swallowing and chewing so that the airway opens up. As a result, the person may snore, snort and/or gasp for air. The person may fall back to sleep and not recall the event, however this cycle of constantly waking up leads to disrupted sleep.
4. Sleep apnea is not a minor issue.
People who have obstructive sleep apnea have three-fold increased risk of death compared to individuals without it. Car crashes occur 2-3 times more often in persons with obstructive sleep apnea leading to a high death rate. Excessive daytime sleepiness and fatigue impair daily function and lead to increased errors and accidents. There is a greater risk for complications around surgeries. There is association with diabetes or insulin resistance, which may be in part due to risk factors associated with both.
5. The risk factors for obstructive sleep apnea are several.
*Overweight – more than half of people with obstructive sleep apnea are overweight. Fat deposits around the upper airway obstruct breathing. However, not everyone with obstructive sleep apnea is overweight.
*People with larger neck sizes. People with thick neck may narrow the airway and may be an indication of excess weight.
*High blood pressure is more common in people with obstructive sleep apnea.
*Narrowed airways, especially from enlarged tonsils or adenoids can block airflow.
*Chronic nasal congestion regardless of the cause.
*Men – men are twice as likely to have obstructive sleep apnea.
*Being black, Latino or Pacific Islander – it is much more common in these ethnic groups.
*Older adults – it occurs 2-3 times more often in adults older than age 65.
*Post menopausal women.
*Family history of sleep apnea.
*Alcohol, tranquilizers, sedatives increase the risk of sleep apnea because they relax the muscles in the throat.
*Smokers are more likely to have obstructive sleep apnea.
6. The basic test for obstructive sleep apnea is typically done in a sleep laboratory. You need to see your doctor for this if you are experiencing:
*Snoring loud enough to disturb your sleep or others
*Shortness of breath that awakens you from sleep
*Intermittent pauses in breathing during sleep
*Excessive daytime drowsiness
7. Home based treatments of milder cases of sleep apnea include:
*Losing weight if you are overweight
*Drinking alcohol moderately or avoid it overall and do not drink several hours before bedtime
*Using a nasal decongestant and/or nasal strips
*Not sleeping on your back. In fact, sleeping on your side or abdomen are the best approaches to improving sleep apnea.
8. Medical therapies for obstructive sleep apnea help to open up the blocked airway. These may include:
*Continuous positive airway pressure (CPAP). This is a machine that delivers air pressure through a mask placed over your nose and mouth. There are different types. Many individuals often complain of discomfort with the mask and may find it difficult to tolerate. Working with your doctor can help find the best fit for you.
*In rare cases, surgical removal of tissue is done, typically reserved for very severe cases.
Hopefully if you follow these steps, you and your loved ones may finally get that night’s rest you have been dreaming about.
Dr. Joseph Sirven is a first-generation Cuban-American. He is Professor and Chairman of the Department of Neurology and was past Director of Education for Mayo Clinic Arizona. He is editor-in-chief of epilepsy.com and has served U.S. and global governmental agencies including the Institute of Medicine, NASA, FAA, NIH and CDC.