What Causes Snoring and Sleep Apnea?

Doctors call snoring and sleep apnea ‘Sleep-Disordered Breathing’, or SBD.  Here we’ll look at what causes these phenomena.

Snoring and obstructive sleep apnea happen because there is a repeated obstruction at the back of the throat or upper airway.  This causes the vibrating noise that we know as snoring, as the air tries to get past the blockage.  But sometimes the person literally stops breathing and this is sleep apnea.  If it happens for about 10 seconds, more than 10 times each hour, this is described as ‘clinically significant’ and can affect your health.

Snoring and sleep apnea experts believe that the obstruction can come from 3 sites:

  1. the nose
  2. and 2 areas in the throat – the velopharynx, which is where the soft palate is, right at the back of the mouth/top of the throat;
  3. and the hypopharynx, which is further down, behind the firm area of cartilage in the throat.

The picture shows this.

Risk Factors For Snoring And Sleep Apnea Are:

  • being overweight
  • carrying this extra weight round your stomach and neck
  • being male (the male:female ratio is 3:1)
  • being a woman after the menopause
  • use of alcohol
  • use of sedative drugs
  • smoking

What happens?

When we’re awake, normal muscle tone and our upright position means that all the areas that might cause obstruction are in the right place for normal breathing.

But when we sleep, everything relaxes and gravity allows them to fall back and obstruct the airway.  This is why snoring is most common when you sleep on your back and why anti snoring pillows try to encourage the sleeper to lie on his side.

Snorers and people with sleep apnea have also been found to have certain physical characteristics.  These include smaller upper airways, more fatty tissue at the back of the throat, a larger tongue and perhaps large tonsils and/or a different jaw shape and position to non-snorers and non-apnea sufferers.

People with nasal problems that cause snoring may have an abnormal shape inside the nose.  This means that instead of the air travelling easily into the nose and down into the lungs, it hits a lot of resistance and turbulence and you end up with the snoring noise.

What’s the Difference Between Snoring and Sleep Apnea?

Snoring is the noise that you (or rather your bed partner/household) hear when you’re asleep.  It’s caused by the vibration of the soft tissues at the back and top of the throat as you breathe.

Sleep apnea happens when these soft tissues block the airway and you stop breathing for a time.

Not all snorers will have sleep apnea.  But all sleep apnea sufferers will also be snorers.  Sleep apnea happens when the sleeper stops breathing.  If it happens for about 10 seconds, more than 10 times each hour, this is described as ‘clinically significant’ and can affect your health.

What Are The Symptoms Of Sleep Apnea?

People with sleep apnea and/or their partners, often say they have symptoms of:

  • loud snoring
  • episodes where they struggle to breathe
  • episodes where they stop breathing for 10 seconds or more
  • choking episodes during sleep
  • wake with headaches in the morning
  • are constantly tired and need to nap during the day
  • depression
  • more falls or car accidents.

Sleep apnea is generally graded as mild, moderate or severe by specialists.

Elspeth Raisbeck

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