What is snoring? What is sleep apnoea (apnea)?
We all know snoring as that irritating noise that disturbs the sleep of the bed partner, family members and other hotel guests. But snoring is far more than just a bad noise. It can have many health complications including the much more serious condition sleep apnoea, where you stop breathing temporarily during sleep for periods that can be as long as a minute – even more. (‘Apnoea’ or ‘apnea’ means ‘without breath’.) Common symptoms seen in people with heavy snoring and sleep apnoea include unrefreshing and interrupted sleep, ‘restless legs’, gasping or choking sounds during sleep, heavy breathing interrupted by pauses (apnea), waking with a snort or feeling like choking or drowning. They may wake so exhausted they feel like they haven’t slept at all, or as if they had run a marathon – legs moving in bed, huge chest-heaving struggles to breathe. (A fuller list of signs and symptoms included below.)
Take them seriously – in adults and children
‘Sleep disordered breathing’ is associated with greater risk of high blood pressure, stroke, cardiovascular disease, Alzheimer’s, diabetes, cancer and of having a car accident. In children, snoring and sleep apnoea are associated with learning and behavioural disorders including ADHD. Treatment is vitally important. Options include nose and throat surgery, nasal medications, wearing a mask (CPAP) and addressing the dysfunctional breathing habits. This last option is fundamental but rarely taken into account from a ‘conventional’ point of view.
What causes snoring? Why does an airway collapse during sleep?
The first thing you need to know is that snoring and sleep apnoea do not occur in people with a normal breathing pattern.
People who snore and have sleep apnoea do not breathe correctly. No exceptions. Research shows they breathe 2-3 times more air per minute than is normal, both when awake and asleep (Radwan.) That is, they overbreathe.
Snoring is high-volume, high-speed breathing
Snorers have a tendency to breathe through their mouth and/or to breathe in too quickly or too heavily. This causes the tissues lining the airway to get dehydrated, swollen and congested, narrowing the airway. During sleep, when the throat muscles are relaxed, these tissues can vibrate and create the snoring noise.
Obstructive sleep apnoea – like sucking too hard on a straw
Breathe in a lot of air fast enough through a narrowed airway and you create a vacuum effect that may actually suck your airway shut and stop you breathing for a while (obstructive sleep apnoea).
Central sleep apnoea – your brain’s response to overbreathing
If through overbreathing you drop the carbon dioxide level in your lungs and blood sufficiently the brain temporarily stops sending the signal to breathe (central sleep apnoea).
Snoring and sleep apnoea are fundamentally problems with the way you breathe … day and night
People who breathe correctly – slowly, smoothly, softly, through the nose – do not snore, draw their tongue into the back of their throat or vacuum their throat closed at night. Nor will they have a mouth so dry in the morning that they have to lever their tongue from the roof of their mouth with a spoon. Faulty breathing habits in the day like mouth-breathing, fast and heavy breathing, frequent sighing, not only inflame soft tissue in your airway, but also alter your brain’s breathing control mechanism and set you up for what happens during sleep. That’s why improving your breathing in the day helps you breathe and sleep better at night – usually from the first night.
You can change the way you breathe
That’s what breathing retraining does – gets you back to slow, smooth, soft breathing day and night. This is what the clinically tested breathing program in Relief from Snoring and Sleep Apnoea is designed to do. This simple and natural approach to the management of breathing disorders is often overlooked in favour of surgical and appliance based approaches. (See below)
Our experience with working with thousands of people is that improvements in sleep usually happen within days and consolidate within weeks. When snoring and apnoea no longer occur (confirmed by repeat sleep study) CPAP machines are no longer required and surgery can be avoided. Many of the people we work with did not find CPAP or a dental appliance tolerable or successful, or did not want to use them for life.
A common comment several days into breathing retraining is: “I was breathing so quietly last night that my husband/wife had to prod me to see if I was still alive.”
Case Study: Gregory had been snoring for as long as he (and his family) could remember. His wife rated his snoring as being at least 8 out of 10. He had recently been diagnosed with sleep apnoea. Gregory had a lot of congestion and more often than not his nose was blocked. After his first consultation he noticed that his mucus decreased. On the third night of his course he found that he slept 8 hours straight without needing the usual overnight toilet visit. He felt totally refreshed and clearheaded in the morning. His wife came home after being away for three weeks and she thought he had died in his sleep! He was the quietest he had been in 40 years.
Getting help for your breathing
Try to breathe just a little more gently when you think of it, say a 1% smaller breath size than your usual, whether its mouth or nose breathing you are doing. Stay comfortable – even a small change should show you a benefit. To go further you need to assess your breathing pattern, determine where ( rate, rhythm, volume, use of breathing muscles, O2 / CO2 balance….) it differs from normal, and change it step by step. Below are some options to help you.
SEE A BREATHING EDUCATOR
Breathing consultations in Tess Graham’s Canberra Breathing Clinic and by phone or Skype – Worldwide
Email: admin@BreatheAbility.com.au or Contact us
ONLINE BREATHING COURSE – WORLDWIDE
The Breathe Away online course in Breathing Retraining. Instructors – Tess Graham and Tracey Anderson Askew. Online Breathing Retraining Course
BOOK AND CD / MP3
The book, Relief from Snoring and Sleep Apnoea was created to help people who may not have access to a breathing educator or who prefer to follow a self-help program. It has a simple, easy to follow explanation, a self-assessment process and a step-by-step guide to changing the way you breathe. Its companion product- Breathing Exercise Instruction Audio makes learning even easier. It is available in CD and MP3 formats.
BETTER BREATHING COURSES in Canberra, Byron Bay, elsewhere (small group 6-8 sessions)
Take the Faulty Breathing Quiz.
Other snoring remedies, sleep apnoea remedies
Traditionally, people are offered
- Surgery: trimming the soft palate; opening or ‘reboring’ nasal passages; tongue and jaw surgery
- Sleep with a dental device (Mandibular Advancement Splint)
- Sleep with CPAP machine (Continuous Positive Airway Pressure) – air-pump machine, tubing, face mask
While these approaches can certainly help reduce symptoms, no appliance, device or surgical procedure will cure snoring and sleep apnoea unless they address the fundamental underlying problem – the abnormal pattern of breathing. Oral appliances and CPAP therapy are generally prescribed for life. However they do not always work, or are not always acceptable or tolerable to the patient. (True CPAP compliance rate is estimated to be well below 50%)
Fortunately you can change the way you breathe. You can replace poor breathing habits with correct and efficient breathing.
Learn more about breathing retraining
Signs and symptoms commonly seen with sleep apnoea include:
Snoring or heavy breathing, interrupted by pauses (apnoea) of 10-90 seconds or more
Restlessness, ‘restless legs’, kicking while asleep
Frequent sleep disturbance
Gasping, snorting or choking sounds during sleep
Mouth-breathing, dry mouth, dry throat
Waking unrefreshed, daytime tiredness
Daytime sleepiness, tendency to fall asleep in meetings, watching television
Memory loss, foggy thinking
Breathlessness with exercise
Many of these symptoms may also be seen in heavy snorers who do not have sleep apnoea.
Untreated snoring and sleep apnoea puts you at greater risk for some serious health disorders including high blood pressure, heart disease, stroke, diabetes and cancer. It is believed that you are 2-7 times more likely to have an accident (road, machinery etc) if you are suffering from snoring or sleep apnoea. Sleep apnoea is usually diagnosed by a polysomnograph or ‘sleep study’.*
Two new studies link sleep apnoea to increased cancer risk
The relationship between sleep disordered breathing and cardiovascular risk is well documented. Now two observational studies are suggesting a strong link with increased risk of cancer. The new research marks the first time that sleep apnoea has been linked to cancer in humans.
* If you have not already been medically diagnosed with sleep apnoea and suspect after reading this that you do have it, go and see your doctor. Significant sleep apnoea is a very serious condition and needs to be addressed in one way or another without delay.
* Participants in breathing retraining programs are requested not to alter or cease medication usage or CPAP or oral appliance usage without first consulting their doctor.
|Radwan L et al, “Control of breathing in obstructive sleep apnoea and in patients with the overlap syndrome”, J. Eur Respir J. Vol 8, 1995, 542–545.Further references see Science|