Snoring can be a lot more than a social embarrassment. It may signal that someone has sleep apnea, a serious sleeping disorder that's a risk factor for stroke, high blood pressure, heart disease, acid reflux and depression.
Sleep apnea is more common in men than in women until women reach menopause; then the numbers even out. And even children can have the disorder, usually because of something anatomical, such as enlarged tonsils.
The disorder is also very treatable, according to Dr. Tom Cloward, a sleep specialist at the LDS Hospital Sleep Disorders Center, and Dr. Robert Farney, the medical director there.
Sleep is the topic the two will address during today's Deseret Morning News/Intermountain Health Care Hotline. From 10 a.m. to noon, they'll take phoned-in questions about sleep disorders like apnea and insomnia, treatments, how to get a good night's sleep and more.
Sleep apnea affects an estimated 2 percent to 4 percent of the population, according to Cloward. It's usually, although not always, characterized by loud snoring. Common symptoms include nonrefreshing sleep, morning headaches, daytime fatigue and tiredness, loud snoring and irregular breathing at night.
The consequences of not treating sleep apnea may be dire: 60 percent of those not treated have high blood pressure. Half of those with heart failure have sleep apnea. So do 70 percent of those with strokes. Which one leads to the other isn't clear. But "we think it's a risk factor for having a second stroke," Cloward says.
Cloward says one of three things usually sends someone with sleep apnea to a sleep specialist: People come in because they're sleeping poorly and feel excessively tired when they should be alert. A bed partner can't bear sleeping with them because they snore so loudly. Or a doctor referred them because of a problem that's often related to sleep apnea, such as high blood pressure or one of the others, which hasn't responded to treatment. The medical problem is either caused by or worsened by sleep apnea and won't get better until the sleep apnea is treated.
Often, he says, it's difficult to distinguish the sleeping disorder from symptoms of depression: fatigue, lethargy, lack of ambition, lack of motivation. "They are called depressed, but they're just tired because of the sleep disorder. Even in patients with clinical depression, if they have sleep apnea, it's difficult to feel nondepressed," he notes.
Two-thirds of those with sleep apnea have it because they're overweight. Obesity is the No. 1 factor, and losing weight may resolve it. Anything that makes someone more relaxed or less inclined to breathe, including muscle relaxants or antianxiety medications, can also be a significant factor to sleep apnea.
"We try to eliminate things they may ingest that can make it worse," says Cloward.
But after those changes are made, the standard treatment, "tried and true," is CPAP, continuous positive airway pressure, delivered by a mask worn when sleeping. It forces the airway open.
Despite its success, though, it's not for everyone. As many as one-fourth of patients simply can't adapt to it. But for the three-fourths who can use it, even new surgical techniques don't work better.
"The good thing about CPAP," Cloward says, "is the engineers who make the masks, the machine, some of them have sleep apnea, so they make better products."