Do you snore? Don’t sleep on it!

According to the World Health Organisation, 100 million people across the world snore and have some degree of sleep apnea. Reassuringly, World Sleep Day, being observed on March 18, has the tagline, ‘Good sleep is a reachable dream.’ So, why do people snore? Obstructive sleep apnea is caused by repetitive upper airway obstruction during sleep as a result of narrowing of the respiratory passages. 

Obesity is one of the major causes of sleep apnea, which reduces the quality of sleep. It is also associated with increased size of the soft palate and tongue. Other causes of sleep apnea are anatomical features, such as a small, receding jaw.

Dr Ravi Ramalingam, Senior ENT Consultant, KKR ENT Hospital & Research Institute, says that snoring may seem innocuous, “But at one point, it becomes a disease in some. Apnea means ‘pause of breath’. 

Typically people start snoring, and after a while, there is a sudden pause, which means that the person is not breathing. This causes the brain to wake the person up and he or she continues to snore again, and this cycle continues throughout the night. This means despite long hours of sleep there is no relaxation,” he says.

It is also characterised by sleepiness, fatigue and impaired alertness. “Such people can doze off as they are sitting and sometimes, dangerously, while driving,” he says. Dr R Narasimhan, founding chairman of the Respiratory Research Foundation of India, adds, “Snoring is the defence mechanism in such cases, and most often, not considered serious. Therefore, there are chances of many cases going undiagnosed.”

Fat deposits in the neck area, which obstruct breathing, is characteristic of an obese individual, says Dr Ravi. “In Tamil Nadu, we are more prone to obesity, given the high rice consumption and we are also the diabetes capital for the same reason. 

Coupled with a sedentary lifestyle, makes those who are overweight a high risk group for sleep apnea.” But such people apart, “Those who have small airways in their noses, throats, or mouths can also have sleep apnea. Even children can have sleep apnea due to the shape of these structures or allergies or other conditions that cause congestion,” Dr Ravi adds. 

Dr N Ramakrishnan, Director, Nithra Institute of Sleep Sciences, says that while worldwide, the prevalence rate of sleep apnea is between 2 to 4 per cent, in India, it is between 8 to 10 per cent. He says, “Men are more prone than women. While diabetes, high blood pressure and obesity are the risk factors, studies show that a huge number of non-obese people have the disorder. At least 40 per cent of diabetics have sleep apnea. There are several implications, including marital disharmony.”

The basic treatment protocol for snoring and sleep apnea includes weight loss and generally, better physical fitness. “Lifestyle modifications are part of the treatment  There are no tablets for it at the moment.” Continuous Positive Airway Pressure (CPAP) is a common therapy for sleep apnea. In this, patients wear a face or nasal mask when sleeping. 

The mask, connected to a pump, provides a positive flow of air into the nasal passages to keep the airway open. There are surgical options for those requiring correction of obstructions,” Dr Ramakrishnan says.