From The Times

Snoring can seriously damage your sex life

Not to mention your health, explains our resident doctor - sleep apnea can lead to heart attacks or stroke

Snoring is the butt of many a joke, but for millions of households across Britain it is no laughing matter. And it's not just a problem for those who have to listen to the noise - snoring can have profound implications for the snorer's wellbeing too, impacting on everything from their sex lives to the odds of succumbing to an early death from heart attack or stroke.

Even in mild cases, snoring can be very disruptive. Recent surveys suggest that as many as 60 per cent of snorers are regularly relegated to the spare room, with the predictable knock-on effect for their sex lives - more than half the couples interviewed admitted to making love less than once a month.

But it is the other extreme that has started to concern doctors in recent years. Heavy snorers can struggle to get their breath when they are asleep, and their oxygen levels can plummet so low that they turn blue. The lack of oxygen triggers a survival response that wakes them briefly to prevent suffocation - a cycle of snoring, obstruction and wakening that can be repeated hundreds of times a night. This results in an awful night's sleep, and predisposes the snorer to a range of health problems, including high blood pressure and heart disease.

The classic story is someone who snores loudly and then appears to hold his breath for anything from 15 seconds to a minute or more, before spluttering and resuming his steady snoring. Poor sleep patterns with multiple awakenings mean that sufferers feel sleepy throughout the day, making them irritable, blunting their judgment and impairing their ability to perform tasks such as driving. It is estimated that as many as one in six lorry drivers may suffer from Obstructive Sleep Apnea Syndrome (OSAS). The resulting fatigue renders them as much of a danger to themselves and other road users as people who drink and drive. Full article available at www.timesonline.co.uk

Snoring linked to weight gain

By sleepdoc

It’s long been recognized that overweight people are more likely to suffer from a sleep disordered breathing (SDB) condition — but there is a growing body of high quality evidence which suggests that it might actually be the other way around.  That is, instead of it being ‘fat people snore’ … it could actually be ’snoring people get fat’.

 Worse still, there is clear evidence that sleep disordered breathing is a significant contributor to hypertension (high blood pressure) and type 2 diabetes.

In one extremely well written paper, by Dr Ralph Pascualy of the Swedish Sleep Medicine Institute, the link between the conditions is explained thus:

 “…several clear relationships have been shown between sleep deprivation and metabolic abnormalities.  Sleep debt strongly affects glucose utilization as well as circadian cycles of thyrotropin, cortisol, growth hormone, and other physiological variables.

Sleep debt alone is reported to result in impaired glucose effectiveness similar to that found in non-insulin-dependent diabetics.  Severe OSA significantly influences plasma insulin and glycemia and may increase the risk of diabetes independently of obesity. Not all OSA patients are obese; however, insulin resistance is found in both obese and non-obese OSA patients. Blood pressure and fasting insulin correlate closely with both BMI and the severity of OSA. Thus, both the sleep debt and the sympathetic activation that accompany OSA may speed the deterioration of glucose tolerance. Insulin resistance and hyperinsulinemia lead to further sympathetic activation, thus completing the circle of obesity, diabetes, hypertension, and the related metabolic abnormalities.”

The full article is available in the ‘Research’ section of The Sleep Therapy Clinic website at www.sleeptherapyclinic.com

FromScience Daily

Snoring Associated With Sleep Apnea May Impair Brain Function More Than Previously Thought

ScienceDaily (June 4, 2009) — It has been linked to learning impairment, stroke and premature death. Now UNSW research has found that snoring associated with sleep apnea may impair brain function more than previously thought.

Sufferers of obstructive sleep apnea experience similar changes in brain biochemistry as people who have had a severe stroke or who are dying, the research shows.

A study by UNSW Brain Sciences, published this month in the Journal of Cerebral Blood Flow and Metabolism, is the first to analyze – in a second-by-second timeframe – what is happening in the brains of sufferers as they sleep. Previous studies have focused on recreating oxygen impairment in awake patients.

“It used to be thought that apneic snoring had absolutely no acute effects on brain function but this is plainly not true,” said lead author of the study, New South Global Professor Caroline Rae.

Sleep apnea affects as many as one in four middle-aged men, with around three percent going on to experience a severe form of the condition characterized by extended pauses in breathing, repetitive asphyxia and sleep fragmentation.

Children with enlarged tonsils and adenoids are also affected, raising concerns of long-term cognitive damage.

Professor Rae and collaborators from Sydney University’s Woolcock Institute used magnetic resonance spectroscopy to study the brains of 13 men with severe, untreated, obstructive sleep apnea. They found that even a moderate degree of oxygen desaturation during the patients’ sleep had significant effects on the brain’s bioenergetic status.

“The findings show that lack of oxygen while asleep may be far more detrimental than when awake, possibly because the normal compensatory mechanisms don't work as well when you are asleep,” Professor Rae, who is based at the Prince of Wales Medical Research Institute, said.

“This is happening in someone with sleep apnea acutely and continually when they are asleep. It’s a completely different biochemical mechanism from anything we’ve seen before and is similar to what you see in somebody who has had a very severe stroke or is dying.”

The findings suggested societal perceptions of snoring needed to change, Professor Rae said. “People look at people snoring and think it’s funny. That has to stop.” Professor Rae said it was still unclear why the body responded to oxygen depletion in this way. It could be a form of ischemic preconditioning at work, much like in heart attack sufferers whose initial attack makes them more protected from subsequent attacks.

“The brain could be basically resetting its bioenergetics to make itself more resistant to lack of oxygen,” Professor Rae said. “It may be a compensatory mechanism to keep you alive, we just don’t know, but even if it is it’s not likely to be doing you much good.”

Adapted from materials provided by University of New South Wales.

Children's snoring may indicate a serious problem

ATLANTA, Georgia (CNN) -- Does your child snore? If so, the American Academy of Pediatrics says to pay close attention.

The academy issued new recommendations Monday telling pediatricians to screen all children for snoring because it could be a sign of a serious illness.

Children who snore loudly may suffer from obstructive sleep apnea syndrome (OSAS). Left untreated, the disorder can lead to growth, heart and pulmonary problems.

As part of a routine examination of patients older than age 1, the pediatricians' group urges doctors to ask whether the child snores. If the answer is yes, doctors should refer the patient for more tests since chronic snoring is often a symptom of obstructive sleep apnea syndrome.

Tonsils and/or adenoids that are too big usually cause the condition, said Dr. Sally Davidson Ward, a pediatrician and member of the academy's subcommittee on the disorder.

Obesity also can result in problems. Fat deposits around the throat can cause it to constrict, and fat in the stomach can prevent the diaphragm from functioning properly. Some 20 percent to 40 percent of obese children suffer from the syndrome, Ward said.

Ward said 10 percent of children in the United States snore and 2 percent have the disorder.

If a child has obstructive sleep apnea syndrome, he or she may be getting too little oxygen and too much carbon dioxide. The condition can lead to poor heart and lung development as well as behavioral problems and even death if unchecked. Problems are reversible if the disease is caught early.

If a child is found to have the syndrome, the first course of action usually is to remove the adenoids and tonsils, the academy said.

Ward said parents can monitor their children's sleeping and, if they snore, ask the following questions:

• Is the child snoring every night?
• Is he or she snoring loudly?
• Does the child gasp for breath?
• Is the child restless?
• Does the child have problems in school, due to fatigue?

If the answers to some or most of these questions are yes, pediatricians may use the information to evaluate the child further and recommend more study and possibly surgery.