Snoring can be bothersome, and it can also be a sign of a more serious condition known as obstructive sleep apnea (OSA). Obstructive sleep apnea is present in three percent of the general population. OSA is characterized by multiple pauses in breathing greater than 10 seconds at a time due to upper airway narrowing or collapse. This lowers the amount of oxygen in the blood, and causes the heart to work harder. Untreated OSA can contribute to high blood pressure, stroke, heart disease, workplace or motor vehicle accidents, and more.
What are the symptoms of obstructive sleep apnea?
- Loud snoring
- Pauses in breathing during sleep
- Waking up gasping or choking
- Waking up with a dry mouth or sore throat
- Daytime sleepiness or fatigue
- Frequent nighttime urination
- Morning headache
- Irritability, mood changes, depression, difficulty concentrating
- High blood pressure, heart disease, stroke, or other cardiac issues
What causes obstructive sleep apnea?
- Poor Muscle Tone in the Tongue and Throat — When muscles are too relaxed, the tongue falls backward into the airway, or the throat muscles draw in from the sides into the airway. Alcohol or drugs that cause sleepiness may worsen muscle relaxation and obstruction.
- Excessive Bulkiness of Throat Tissue — Overweight people may have excess soft tissue in the neck that can lead to airway narrowing. Those with very large tongues are especially susceptible to snoring and OSA. Cysts or tumors are rare causes of airway narrowing.
- Long Soft Palate and/or Uvula — A long palate narrows the opening from the nose into the throat. The excessive length of the soft palate and/or uvula acts as a noisy flutter valve during relaxed breathing.
- Obstructed Nasal Airways — A stuffy nose requires extra effort to pull air through it. This creates a vacuum in the throat that pulls together the floppy tissues of the throat. Sometimes, snoring only occurs during allergy season or with a cold or sinus infection.
- Uvulopalatopharyngoplasty (UPPP) is a plastic surgery of the throat involving tissue repositioning, or removal of excess soft tissue, to open the airway. The remaining tissue stiffens as it heals, helping to minimize tissue vibration. A tonsillectomy can also help enlarge the airway.
- Thermal ablation procedures reduce tissue bulk in the nasal turbinates (structures on the side wall of the inside of the nose), tongue base, and/or soft palate. These procedures are used for both snoring and OSA, and several treatments may be required.
- The soft palate may be stiffened by inserting stiffening rods into the soft palate, or by injecting an irritating substance that causes stiffness in the injected area near the uvula.
- Hypoglossal nerve stimulator technology implants a tongue pacemaker, which stiffens and projects the tongue forward during sleep. Other procedures may be used to surgically target tongue muscles or the boney configuration of the midface.