Snore, Snore, Alarm, Alarm, No One Listening?

Snoring is an alarm. In general, the louder the alarm, the bigger the problem. If an alarm is going off, do you ignore it, turn it off or try to find out why it's going off?
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A very common reason for consultation offered by patients in my sleep medicine practice is, "My [bed partner] is complaining about my loud snoring."

"He/she is frightened when I snore, then gasp or choke in sleep."

The best-kept family secret is often let out during the discussion that ensues: "We have not slept in the same room for years because of how loud my snoring is."

In other situations: "I go to sleep after my partner because he/she can not fall asleep with me snoring."

And the partner, if present, will often say: "Can you do something to stop him/her from snoring so loudly?"

On the other hand, when asked about a child's snoring, parents usually smile, look at each other and point to each other: "Everyone in our family snores. Is that a problem?"

Snoring is an alarm.

In general, the louder the alarm, the bigger the problem. If an alarm is going off, do you ignore it, turn it off or try to find out why it's going off?

In order to sleep restfully, the body's design requires two things in terms of breathing:
  • Breathe through the nose.
  • Breathe without an effort.

As you fall asleep, air passes through the nose and may hit some source of obstruction, which leads to vibration of tissues due to turbulence of airflow. Snoring is the noise of that air turbulence. Louder snoring means greater difficulty in the flow of air, which also means the body has to overcome that resistance by making an effort to get the air down into the lungs.

As you drift deeper into sleep, snoring starts, and then gets louder. As an increasing effort is needed but deeper sleep does not allow that effort, a state of balance occurs resulting in no air passing through. You stop breathing, which is called an "apnea," or sometimes breathe too shallow, termed "hypopnea."

Oxygen levels start dropping as breathing stops. The brain, with a very reliable safety backup mechanism, detects the problem and wakes you up, partly or completely, and a sudden deep breath occurs -- which is the gasping or choking noise that seems so frightening to the observer. The sudden deep-breathing effort also pulls stomach acids up and can cause the chest pain of acid reflux, or a bad taste in the mouth.

The cycle can keep repeating many times during each hour of sleep.

Disruption of restful sleep due to this breathing problem has many implications on a person's health.

Some of those are:

  • Tiredness and sleepiness during the day, sometimes leading to accidents.
  • Aggravation of anxiety, depression and other psychological issues.
  • Inattention, impulsive and hyperactive behavior in children.
  • Dependence on caffeine and nicotine to stay awake, alert and functioning through the day.
  • Increased food cravings, slowing of the metabolism, and weight gain.
  • Increased blood pressure and aggravation of underlying heart disease.
  • Increased blood sugar levels and aggravation of diabetes.
  • The need to wake up and urinate during the night, or bedwetting in children.
  • In young and otherwise healthy people, premature aging.
  • In people with existing heart and lung problems, it can lead to heart failure, heart attack, stroke and death.

The interesting fact about this problem is that it can be completely correctible and fully treatable with improvements in all of its ill effects on a person's life and health. The treatment is also not a pill that can come with its accompanying side effects.

The gold standard treatment is called "continuous positive airways pressure" (CPAP). Pressurized air titrated to the individual person's requirement is blown into the nose to keep the air passages open, right where the problem is; a simple and direct approach to the problem.

Go talk to your doctor. This is not a problem worth having.

For more by Amer Khan, M.D., click here.

For more on sleep, click here.