By Allan R. Handysides and Peter N. Landless
My husband has a peculiar sleep pattern. He breathes deeper and deeper, then stops breathing, only to start breathing again with a kind of snort! He then pants a bit, slowly settles down, and then repeats the pattern. I make him roll over, but I’m not getting a good rest myself. And he seems to be more irritable than he used to be. Do you think this kind of snoring could be helped by surgery?
What you have very nicely described is “sleep apnea.” This is a problem that’s becoming more common and may well be a reflection of the increased prevalence of overweight individuals among us.
Sometimes called “obstructive sleep apnea,” this is when the upper airway is narrowed, causing the respiratory muscles to work harder—but there are many more ramifications than that.
Millions of people worldwide have sleep apnea. It’s more common as the population ages, and more frequently found in men—especially those who are overweight, smoke, have thicker necks, and possibly have more soft tissue in their nasopharyngeal area.
Sleep apnea is a factor in high blood pressure. The rise in blood carbon dioxide and the fall in blood oxygen tension may be involved in triggering vascular changes.
It’s well recognized that as a group, people with sleep apnea are more likely to have ischemic heart disease, cardiac rhythm irregularities, and heart failure in their ranks than a control population.
It’s not surprising that your husband may be more irritable, because he’s not getting proper rest—and neither are you. People with sleep apnea are often tired during the day, complain of headaches, and exhibit forgetfulness. Some males may notice sexual dysfunction, and should be carefully screened for hypertension.
Some people have had relief from what has been called “somnoplasty.” This is a surgery in which soft tissue at the back of the throat is removed. The procedure involves the uvula and the soft palate. It can bring benefits, but by far the most useful treatment is something called CPAP. The letters stand for Continuous Positive Airway Pressure. A device that increases the pressure in the airway is used to hold the airway tissue open during sleep. This takes a little getting used to, but the patients readily adjust to the apparatus and soon learn to appreciate the benefits enormously. By reducing the fluctuations in oxygen and carbon dioxide levels, CPAP removes some of the underlying mechanisms that may predispose to hypertension and heart risk.
Of course, CPAP should not be viewed as the definitive treatment. Most people with sleep apnea would improve enormously if they lost weight. You do not mention your husband’s weight, but I would guess he is some 20 pounds overweight. If this is the case, help him by reducing portion sizes at mealtime and encourage him to eat nothing between meals. People who consume a lot of fat, as in red meat, cheese, and greasy food, can reduce calories by avoiding such items. Many eat a lot of bread, and reducing this also will help him lose weight. Recently, guidelines on sugar consumption were given that recommend no more than seven teaspoonfuls a day for women and nine for men. This is easily exceeded when one considers that many soft drinks, which really are only flavored sugar water, contain up to 11 teaspoons per serving.
Don’t forget to encourage exercise. Begin with walking regularly. This will help by improving metabolic efficiency.
We also suggest you visit your doctor; it sounds like your husband needs to be under active medical management.
Allan R. Handysides, M.B., Ch.B., FRCPC, FRCSC, FACOG,
is director of the General Conference Health Ministries Department.
Peter N. Landless, M.B., B.Ch., M.Med., F.C.P.(SA), F.A.C.C.,
is ICPA executive director and associate director of the General Conference Health Ministries Department.