Snoring and Sleep Apnea

What is Snoring?

Snoring is a disruptive social problem that affects not only the person who snores but also other family members.

It occurs due to the narrowing of the airway during sleep, caused by the relaxation of the soft tissues in the throat area. This narrowing leads to the rapid passage of air through a constricted airway, causing the unsupported tissues of the upper respiratory tract to vibrate, producing loud noises. Snoring is observed in approximately 25% of men over the age of 45.

What is Sleep Apnea?

Sleep apnea is a sleep disorder characterized by repeated pauses in breathing during sleep, each lasting 10 seconds or longer. Snoring and sleep apnea are about twice as common in men as in women. This is explained by the fact that men tend to accumulate fat in the upper part of the body, particularly in the neck area, while women tend to accumulate fat in the lower body.

Between 4% and 10% of middle-aged men experience both snoring and sleep apnea. In addition to gender, excessive fat accumulation is also known to have a negative impact. Sleep position is another important factor that affects the morphology and size of the upper airway, contributing to sleep apnea and snoring.

Snoring and Sleep Apnea

Snoring can also be a symptom of sleep apnea. However, only about 10% of snorers have sleep apnea. Studies have shown that one in three men and one in five women who snore have sleep apnea.

Repeated pauses in breathing during sleep reduce the amount of oxygen in the body throughout the night, which can lead to cardiovascular diseases in the long term. Among women aged 40-65 who snore, cardiovascular diseases are detected at a higher rate compared to those who do not snore.

Additionally, sleep apnea can result in arrhythmias, increased heart rate, and elevated blood pressure. This is due to the drop in blood oxygen levels caused by repeated pauses in breathing during sleep. The increase in blood pressure can cause the walls of the blood vessels leading to the brain to thicken and develop plaques, disrupting blood flow to the brain and increasing the long-term risk of stroke and other cardiovascular events. If left untreated, individuals with sleep apnea may face serious cardiovascular and neurological conditions, including sudden death.

Polysomnography (Sleep Test)

The diagnosis of sleep apnea is made using a sleep test called "polysomnography." This diagnostic test is requested for patients presenting with complaints of snoring and pauses in breathing during sleep. Polysomnography is a test that records brain activity, respiratory events, and many other parameters throughout the night. The diagnosis of the disease is confirmed when the results show pathological levels of sleep-related breathing disorders.

During a polysomnography test, brain waves, eye movements, muscle activity, heart rate and rhythm, and oxygen levels in the blood circulation are measured.

How to Prevent Snoring?

Preventing snoring involves addressing the factors that cause it and making some lifestyle changes. If there is an obstruction in the upper airway, surgical interventions may benefit the patient. Avoiding alcohol and sleeping pills, losing weight, and not sleeping on your back are some lifestyle changes that can be effective.

Snoring that does not cause pauses in breathing during sleep can be prevented by changing the sleep position, sleeping on a higher pillow, losing excess weight, and avoiding alcohol and smoking. However, if the severity of snoring does not decrease despite these measures, the person should consult an ear, nose, and throat specialist.

After an examination and additional tests conducted by a physician, the factors causing the snoring are identified, and appropriate treatment, including surgical options if necessary, is arranged. In some cases, the use of an "oral appliance" may be recommended.

An oral appliance is a type of prosthesis made specifically for the individual by a dentist. It is worn in the mouth before sleep to prevent the tongue from moving backward and to increase the oral cavity space. Another treatment option is surgical intervention. However, before performing surgery for simple snoring, the person should be monitored in a sleep laboratory, and their sleep should be analyzed. In some cases, snoring may not be a nuisance but rather a symptom.

How is Sleep Apnea Treated?

1. Lifestyle changes
2. Positive pressure airway therapy
3. Surgical treatment

1. Lifestyle Changes

• Losing weight
• Quitting alcohol and smoking
• Avoiding sedative medications

2. Positive Airway Pressure Therapy for Sleep Apnea

Patients diagnosed with sleep apnea during their first night in the sleep lab are admitted a second night for treatment, especially those with moderate to severe sleep apnea. The most effective treatment method is the use of a sleep apnea device called CPAP, which provides positive airway pressure to the upper airways. This device keeps the upper airways open continuously during sleep, preventing apnea. The device is used with a silicone air mask. The treatment also addresses the snoring issue.

CPAP provides near-complete relief from sleep apnea symptoms in adults and is the most effective treatment method. Despite its effectiveness, some patients may find it challenging to adapt to using the device due to various discomforts. However, most patients easily adapt to the device by adjusting the size of the mask and its straps according to their personal experience. There are also different types of positive pressure devices available. The most suitable device that controls the patient's apnea and snoring throughout the night is recommended.

3. Sleep Apnea Surgery

1. Tissue Removal
2. Tissue Reduction in Sleep Apnea
3. Jaw Correction Surgery
4. Nerve Stimulation
5. Sleep Apnea Tracheostomy