20-11-24
Snoring is a quite common problem that affects both the sufferer and their partners, where in some cases it can also take on social dimensions.
It usually affects 20% of adults, while occasionally it can occur in up to 40% of them. The intensity of snoring ranges from mild (produced sound equal to 40 dB) to very loud (90 dB). It can be intermittent or continuous, while in more serious cases (35% to 55%) it can be combined with sleep apnea syndrome.
Sleep apnea is defined as the complete cessation of breathing during sleep for a period of at least 10 seconds. The number of apneas ranges from 5 per hour (mild form) to over 30 per hour (severe). Apnea is divided into obstructive, central and mixed. Obstructive apnea, which is the most common, is due to the obstruction caused by the contraction of muscles at some point in the airway. In this way, the lungs are unable to draw air into the chest. Central apnea is caused by damage to the brain or nervous system, resulting in the muscles that control breathing being affected. Finally, mixed apnea is the combination of obstructive and central.
What are the common causes of snoring or apneas?
Any disturbance in the free flow of air in the airway, that is, in the path of air from the nose and mouth to the lungs, can cause snoring and/or apneas. Obstructive apneas are due to any obstruction that can be caused by various anatomical or functional problems of the nose, such as a deviated nasal septum, hypertrophic nasal turbinates, adenoid hypertrophy, chronic allergic rhinitis or nasal polyps. Also, various problems may coexist in the mouth, pharynx and/or neck, such as hypertrophy of the tonsils, large/loose uvula, large tongue, micrognathia, short neck. Additional aggravating factors are weight gain/obesity, alcohol or food consumption, especially before bedtime, smoking and the use of sedatives and hypnotics.
How much does snoring and apneas affect our health?
In most cases, snoring, beyond its social implications, is not a health risk. However, in individuals who experience snoring in combination with sleep apnea syndrome, it can cause mild to severe health issues for the sufferer. Specifically, apneas can affect the person's daily life, with the presence of daytime sleepiness, morning headaches, fatigue, irritability, lack of concentration and sexual dysfunction. More serious problems involve the gradual drop in saturation (drop in oxygen in the blood) with the appearance of accompanying problems such as hypertension, arrhythmia, heart failure, heart attack and/or stroke.
When should you see a doctor and what tests are required for diagnosis?
In cases where snoring is very intense and especially if it is accompanied by episodes of apnea, then the sufferer should definitely seek medical help. Taking a detailed history with a thorough clinical examination can in most cases identify the causes of the problem. In some cases further tests are required, such as CT or MRI scans and a sleep study. The latter is a detailed examination performed during sleep, where various functions of the body are recorded, such as the intensity of snoring, saturation (oxygen level in the blood), electrical activity of the brain and muscles, eye movements, heart function and respiratory effort.
What is the treatment for the problem?
Depending on the severity and cause of the problem, the treatment can be conservative or surgical. In simple snoring, weight loss, physical exercise, avoiding alcohol and large meals before bedtime and reducing or stopping smoking are recommended. In cases of obstructive apnea, depending on the point of obstruction, septoplasty, reduction of the nasal turbinates, tonsillectomy, adenoidectomy, partial excision of the uvula and pharyngo-palataloplasty (UVPP) are recommended.
What treatments are usually recommended?
The treatment of both simple snoring and obstructive sleep apnea syndrome is conservative or surgical. Surgical procedures for obstructive apnea in recent years have been greatly simplified and some of them are even performed with local anesthesia and without particular pain. Common procedures, always depending on the point of obstruction, are the correction of a deviated nasal septum.