What is snoring?
-Snoring occurs due to fluttering or vibration of the narrowed upper part of our airways, which is the normal passage for flow of air while breathing. Various parts of the airways (tongue, tonsils, palate, wall of the throat) tend to collapse and constrict the passage, leading to turbulence in airflow and the sound of snoring.
Why does snoring occur only during sleep?
-Snoring occurs only while sleeping as this passage becomes even more narrow at that time. Muscles around the passage relax and structures like the tongue and palate (taalu in Hindi) come closer to narrow the passage partially or completely. This may lead to a decrease in flow of air while breathing, which may even stop completely for a few seconds.
Is snoring a disease?
-YES. Snoring loudly or regularly is a disease and may need evaluation by a Sleep Specialist. People who are obese or overweight tend to have higher chances of snoring, often due to increased deposit of fat in the tongue and around the breathing passage. Repeated opening and collapsing of the airways also causes inflammation or swelling in the tissues, further narrowing the passage. Snoring is often associated with Obstructive Sleep Apnea (OSA), a common but poorly recognized condition with harmful effects on our body.
How common is OSA?
-There may be over 900 million cases worldwide. Around 10% of Indians (14-15 crore) OR 1 out of 10 people in India, likely suffer from this condition. The disease is highly unrecognized and under- reported, and the numbers may be much higher than what we think.
What is Obstructive Sleep Apnea (OSA)?
-Obstructive Sleep Apnea (OSA) is a condition where the upper part of our airways gets partially or completely blocked during sleep. This causes our breathing to become slow or stop completely for a few seconds. When breathing stops/slows down for up to 10 seconds, our oxygen levels start falling. This sends an urgent signal to the brain to activate our sympathetic nervous system, which is the “fight or flight response” of our body.
-The brain becomes aroused and awake, sending signals to various organs, including the muscles of the upper part of our airways and tongue, to open the narrowed passage, allowing normal breathing to resume.
What are the symptoms of OSA?
-Symptoms of OSA are similar to what we feel the day after not having slept well the previous night. People feel their sleep was of a poor quality and may feel tired, fatigued or sleepy the entire day. They can have early morning headache, difficulty concentrating, low attention span and may think they have “short-term memory loss” or “brain fog”. Irritability, mood swings and hyper-activity may be seen, even in children. Children may show a recent fall in their performance at school.
-At night, people tend to get up frequently and may often report having strange or threatening dreams. At times they wake up drenched in sweat or with a dry mouth/sore throat. Their bedpartner will often complain of loud snoring in the OSA patient or may notice that their breathing suddenly stops while asleep, suddenly resuming with a choking or gasping action.
-Often others notice them sleeping while sitting, especially during mundane activities like watching TV or a movie, travelling in a vehicle, and at times such people have been known to fall asleep while driving, resulting in catastrophic road accidents.
Why does OSA affect our ability to concentrate? Does it affect our memory as well?
-In OSA, our brain gets activated when airway collapses, sending signals to open it up. This frequent awakening of the brain, which may happen hundreds of times during the night, leads to light and fragmented sleep. REM sleep (when dreaming happens) is often not achieved. People often feel they
have either not slept at all, or it was a very disturbed sleep. Deep sleep, specially REM is important to form long-term memories, which may get affected in OSA. Students often notice difficulty in retaining what they studied just the day before, if their sleep is fragmented.
How does OSA affect our organs?
Activation of brain also activates the heart and blood pressure control, leading to fluctuations in heart rate, rhythm and high blood pressure. OSA causes diseases of the blood vessels, with increased risk of heart attacks (including silent attacks), sudden cardiac death (often while sleeping), and stroke.
Weight gain increases the risk of OSA which in turn causes insulin resistance and further gain in weight. Thus, OSA is a condition with major health concern, and it becomes important to understand and diagnose it.
How is OSA diagnosed?
The diagnosis requires evaluation by a Sleep Specialist and undergoing a sleep study (polysomnography), which can often be conducted in the comfort of one’s home. A basic sleep study measures the number of times one’s breathing becomes slowed or completely stops during the entire night and measures oxygen levels in the blood during sleep.
People with symptoms of OSA, especially along with chronic health conditions like heart disease, high blood pressure, history of heart attacks or stroke, must consult a Pulmonology and Sleep Specialist.
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