Effects of Snoring and Sleep Apnea
The negative effects of snoring and sleep apnea (apnoea) are many and varied.
At the ‘social’ end of the spectrum, snoring can be a severe embarrassment to the snorer and often disrupts other people’s sleep. Negative impacts on conjugal relationships are not uncommon, with ‘separate room’ sleeping arrangements becoming a way of life for many snorers and their partners. In some cases, snoring has even lead to the breakdown of otherwise happy relationships.
At the ‘medical’ end of the scale, snoring and sleep apnea inevitably disturb the sleeping patterns of the snorer and their partner and thus deprives them of necessary rest.
One result of this is the fact that sufferers of 'sleep disordered breathing' (SDB) are up to 7 times more likely (than a healthy sleeper) to be involved in a motor vehicle accident. This is why licensing authorities in all Australian States and Territories specifiy 'sleep conditions' as a notifiable condition, along with blindness and epilepsy.
Untreated sleep disorders could mean revocation or restriction of licence, but effective treatment avoids this. See the section on 'Are You Fit To Drive?' for more details.
Snoring is indicative of the development or existence of a more serious sleep disorder.
Snoring is the sound of someone struggling to breathe. The soft tissue of the upper airway sags and reduces in size. Breathing becomes more laboured as a result, and the vibration of the soft tissue creates the snoring noise.
As we age, lose muscle tone and put on weight this can grow worse, utlimately to the point where the airway is blocked, known as obstructive sleep apnea.
The consequences of 'sleep disordered breathing' (SDB) are summarised in a report by the Queen Victoria Hospital Sleep Studies Unit (in the UK), which said:
“If snoring worsens, it may lead to disrupted sleep. The subject wakens in the morning with a feeling of having slept poorly, and finds the day is difficult to cope with due to tiredness and lack of energy. In extreme cases, they fall asleep in any given situation, even during conversation, and most dangerous, when driving.
It is likely that many road accidents, particularly those on motorways where boredom sets in, are caused by going to sleep at the wheel, and this should be taken very seriously by those with this problem.
Usual symptoms are:
- snoring or stopping breathing at night
- wakening unrefreshed or feeling of poor quality sleep
- wakening with morning headaches
- wakening in the night with a feeling of obstruction in the throat
- wakening with panic or inability to breath
- restless sleep causing a crumpled bottom sheet
- passing urine several times a night
- difficulty keeping awake during the day
- lack of concentration
- going to sleep when not concentrating (eg. on arrival home at night)
- decreasing motivation and enthusiasm for life e.g. at weekends
- inability to get started on tasks at home that once were easy to perform
- weight gain and increasing collar size
Thus, a 'slobbish' syndrome develops where there is decreasing exercise, increasing weight and a lethergic attitude to life.”
Unfortunately, it can get much worse. According to a Position Statement of the Academy of Sleep Medicine:
- Untreated snoring and apnoea is associated with increased risk of morbidity (complications) and mortality (premature death). The probability of death within a defined period of time increases with increasing severity of SDB. Untreated SDB probably contributes to hypertension, strokes, heart attacks, and automobile accidents.
- Before being treated for SDB, people with SDB, in contrast to matched control groups without SDB, get hospitalized more often (about three times more often), stay in hospitals longer, and cost more (about twice as much) for doctors and overall health care.
- From a single study, patients receiving treatment for SDB, compared to untreated controls, costed 1/3 less for doctors and spent less time in the hospital.
Similar results were reported in studies conducted by BUPA. (BUPA is the British United Provident Association - a global healthcare organisation with members in nearly 190 countries. The BUPA Foundation is an independent medical research charity that provides finance towards the prevention, relief and cure of sickness and ill health. )They state:
“Your breathing stops, cutting off the flow of oxygen into your body and reducing the elimination of carbon dioxide (CO2) from the blood. Your brain detects this rise in CO2 and briefly wakes you up, re-opening your airways and re-starting your breathing. This process can be repeated several times during the night. Proper sleep may become impossible, resulting in severe fatigue and a decreased quality of life.
Sleep apnoea in adults can increase the risk of serious health problems such as heart failure, because it deprives the sufferer of adequate levels of oxygen, making the heart work harder than normal. Obstructive sleep apnea is serious if the episodes last more than ten seconds each and occur more than seven times per hour. Apnea patients may have 30 to 300 such events per night. Blood oxygen levels may fall, causing the heart to pump harder. A myocardial infarction (heart attack) is possible.
Effects on the patient:
- The patient sleeps lightly with tensed muscles.
- The patient may have morning headaches.
- The patient is fatigued and may even fall asleep during the day. This is especially dangerous while driving or if working around machinery.
- The patient may develop hypertension (high blood pressure) or heart problems. The immediate effect of sleep apnea is that the snorer must sleep lightly and keep his muscles tense in order to keep airflow to the lungs.
- Because the snorer does not get a good rest, he may be sleepy during the day, which impairs job performance and makes him a hazardous driver or equipment operator.
- After many years with this disorder, elevated blood pressure and heart enlargement may occur.”
These findings have been confirmed by a recent study at The Alfred Hospital's Sleep Disorders Centre (in Melbourne, Australia). The study confirmed a clear link link between snoring and heart disease and claimed that it could be as serious as smoking or diabetes. The study was published this year in the American Journal of Respiratory Critical Care Medicine.
(Source: The Australian Broadcasting Commision)
Snoring arising from the base of the tongue can cause partial or complete airway obstruction due to a collapse of the throat, which is essentially a muscular tunnel. If the muscles relax too much, the walls of the tunnel fall in and this inhibits inspiration (breathing in). There may only be a partial collapse, but the effect nevertheless is that the muscles of breathing have to work harder to drag air into the lungs past this obstruction.
Where complete cessation of breathing occurs the condition is called Obstructive Sleep Apnea (OSA). Cessation of breathing may last anywhere from at least ten seconds to two minutes or more. Apnoea patients may experience up to 300 such events per night. These episodes often lead to significantly reduced blood oxygen levels.
Obstructive sleep apnoea is graded as mild, moderate or severe. Typically, sleep apneoa is considered mild when the patient has from five to fifteen breathing stoppages (apneic events) per hour. Moderate OSA is when the patient has 15 to 30 events per hour, and severe is when the patient has more than 30 events per hour. Some patients only exhibit apnoea, or the apnoea becomes more severe, during rapid eye movement (“REM”) sleep. Others suffer during all stages of sleep.
REM sleep occurs when the patient is dreaming and the body suspends itself into a flaccid paralysis, reducing muscle tone to its lowest level. The airway is therefore most susceptible to collapse during REM sleep. Arousal during REM sleep is especially harmful to the patient because it is during REM sleep that the body gains significant restorative and regenerative benefits.
OSA can lead to severe fatigue at best and sudden death at worst. If you think you have this disorder, you should seek treatment from a medical professional.
According to various scientific studies:
- An individual with untreated ‘obstructive sleep apnoea’ (OSA) is up to 4 times more likely to have a stroke and 3 times more likely to have heart disease. (National Sleep Foundation).
- Patients with untreated apnoea run a 3% risk of stroke and heart attack. Treatment was found to lower blood pressure and reduce the risk of stroke by 20% (The Lancet 2002; 359: 204-210)
- About one half of patients who have essential hypertension (high blood pressure) have obstructive sleep apnoea, and about one half of patients who have obstructive sleep apnoea have essential hypertension. (Am Fam Physician 2002;65:229-36)
- People suffering from sleep apnoea are six times more likely to be involved in a car crash (as a result of drowsiness) than those without sleep disorders. (New England Journal of Medicine)
Once again, the good news is that there are a variety of effective treatments available for sleep disordered breathing. For information, call 1300 246 637 for a free, no-obligation chat with a friendly Care Coordinator. Alternatively, just fill in the form below and we'll get back to you promptly.