You Snore Like a Tractor!

Have you been told you snore like a tractor? It could be more than just snoring. You might have sleep apnea.

What Is Sleep Apnea?

Sleep apnea is a severe disorder that causes your breathing to stop repeatedly while you sleep. These breathing pauses or "apneas" usually last 10 to 30 seconds and can happen many times throughout the night. Often, individuals can go up to a minute or longer without breathing, which can occur hundreds of times throughout the night. The problem is that they are never aware it's happening.

There are three types of sleep apnea: obstructive, central and mixed. Obstructive sleep apnea is the most common of the three occurring when the muscles in the back of the throat relax and obstruct the airway during sleep. The blockage can also happen when the soft tissue in the back of the throat collapses and closes during sleep. Additional culprits in possibly blocking the airway are relaxed throat muscles, a narrow airway, a large tongue or extra fatty tissue in the throat.

Central sleep apnea, a more rare form of apnea, occurs when the brain fails to maintain breathing during sleep. Lastly, mixed sleep apnea (also rare) refers to a combination of the other two types.

Signs and symptoms of sleep apnea

Family members or bed partners often pick up on the signs of sleep apnea first. Many people with sleep apnea don't know they're snoring and gasping for breath at night. 

The most common symptom of sleep apnea is chronic snoring. Now, snoring by itself doesn't necessarily mean that you have sleep apnea. Loud snoring is common in people with this disorder, but there's a big difference between simple snoring and sleep apnea.

Other symptoms include:

• loud snoring followed by silent pauses
• gasping or choking during sleep
• Daytime sleeping
• morning headache
• irritability or mood changes
• Difficulty concentrating or memory loss
• depression
• lowered sex drive
• falling asleep while driving

Risk Factors

Over one in four Canadian adults (26%) is at high risk for having obstructive sleep apnea based on the presence of three or more of seven risk factors/symptoms for obstructive sleep apnea: 

• snoring loud enough to be heard through closed doors; 
• often feeling tired, fatigued, or sleepy during the daytime; 
• having been observed to stop breathing during their sleep; 
• having been diagnosed with high blood pressure; 
• having a body mass index (BMI) greater than 35 kg/m
• being over the age of 50 years
• being male.

Sleep apnea is prevalent. An estimated 5.4 million Canadian adults have been diagnosed with sleep apnea or are at high risk of experiencing obstructive sleep apnea (OSA). It is a severe disorder because it can put individuals at risk of developing other medical conditions such as:

• high blood pressure
• stroke
• heart attack
• motor vehicle collisions
• depression
• decreased sexual function
• work-related injuries
• Falling asleep while driving

Diagnosing Sleep Apnea

Diagnosing sleep apnea often requires a sleep study at a sleep center. During the study, specialized equipment is used to monitor various functions of sleep. This includes observing how often and how long you are going without breathing. Heart function, brain waves, blood oxygen levels, and eye and muscle movement are also measured. 

Nowadays, it can be much more straightforward. The equipment is worn while sleeping at home in your bed, and readings and data are taken remotely at the clinic office. 

Treatment and Management

There are easy and effective treatments for sleep apnea. Your treatment will depend on whether your sleep apnea is mild, moderate or severe. Your doctor can help you choose the best treatment for you. The most common treatment for sleep apnea is CPAP or continuous positive airway pressure. CPAP involves wearing a special mask that keeps the throat open, stops the snoring, and pauses breathing.

The key is to confirm whether you have sleep apnea so you can start treatment. If you have any of the signs and symptoms listed above, see your doctor. Your doctor may send you for overnight testing at a sleep disorder centre where your condition can be studied thoroughly. You may also be required to do some home tests.

Lifestyle changes - like losing weight and exercising - can reduce sleep apnea symptoms and help reduce other risk factors for heart disease and stroke. If you have mild sleep apnea, some lifestyle changes may get rid of the symptoms altogether. Here are some of the things you can do:

Lose weight

Being overweight is a risk factor for sleep apnea. If you're overweight, ask your doctor for advice on how to lose weight safely. Weight loss of just 10 percent - that's equal to 20 lbs for a 200 lb man - can significantly reduce the number of sleep apnea episodes that happen each night.

Get moving

Exercise isn't just a great way to maintain a healthy body weight but also contributes to healthy sleep. (Try not to exercise for at least three hours before bedtime. A hard workout right before bed might cause trouble sleeping.)

Stop smoking

Smoking can worsen sleep apnea symptoms because it can irritate your throat and make you cough at night. Stopping smoking will also give you more energy for everyday physical activities.

Stick to a regular sleep schedule

Going to bed and waking up at roughly the exact times every day helps you get the right kind of sleep. It would be best if you experienced the full cycle of deep- and lighter-stage sleep to feel well-rested. A regular sleeping schedule also prevents you from getting overtired, which can make sleep apnea symptoms worse.

Avoid alcohol and sleeping pills

If you have trouble sleeping, try a cup of decaffeinated herbal tea or juice instead of unwinding with a glass of wine. Alcohol and certain medications (sleeping pills and some pain medications) can relax the throat muscles more than usual. As a result, airways can get blocked. Alcohol and drugs can also make it harder for your brain to "wake up" and register a lack of oxygen in the body. This can cause more extended and more severe pauses in breathing. If you find it hard to fall asleep, try reading a book or taking a warm bath.

Sleep on your side

Sleeping on one side instead of sleeping on your back can help to improve sleep apnea symptoms. Sleeping on your back lets gravity pull on the tissues at the back of your throat and neck. This can cause the upper airway to become narrow or collapse completely. You can "train" yourself to sleep on your side by putting pillows against your back to prop yourself on your side.

Pharmacists see many patients that regularly fill their prescription for sleeping pills because they are exhausted and not getting a good night's sleep; perhaps it’s time to talk about another option. 

To understand the impact of sleep apnea visit: https://www.canada.ca/en/public-health/services/chronic-diseases/sleep-apnea/what-impact-sleep-apnea-on-canadians.html