By Linda Wasmer Andrews - April 17, 201S
Sharing a bed with a snorer can put a serious strain on your relationship - and health. Fatigue isn't the only worry. Your partner's nighttime noises could signal sleep apnea, a potentially life-threatening condition. Learn to spot trouble signs and get expert-recommended snoring remedies that can help save your relationship and well-being…
When a spouse's snoring is relatively quiet, many spouses learn to ignore it. But when his noises go from sawing a few logs to leveling a forest, it's harder to tune out. Sometimes it can make or break a relationship.
Her husband's snoring was one problem that ended the marriage of Sally Franz, 60, a corporate trainer and humor writer.
"It was so loud, I had to move to another floor of the house," she says.
Making matters worse, Franz felt that her husband wasn't willing to work with her to find snoring remedies. Eventually, they divorced.
"When everything else is going south and you're also sleep-deprived, it can be a huge factor," she says.
A Common Relationship Problem:
About half of all adults snore at least occasionally, and a quarter do it loudly and often, according to the National Heart, Lung and Blood Institute. Men are twice as likely to snore as women, because of anatomical differences in the throat.
If you're married/partnered to one of these men, you know snoring can be more than a minor annoyance.
How Snoring Starts:
Snoring is produced by the soft tissues in the throat. The throat, tongue and soft palate (roof of the mouth) relax when you sleep, sometimes so much that they obstruct airflow. This creates air turbulence, making tissues vibrate noisily.
Other anatomical factors can disrupt airflow too. Some snorers have a bulky soft palate, a long uvula (the triangular flap that hangs down from the soft palate), a large tongue base, enlarged tonsils or swollen nasal turbinates (shelf-like structures inside the nose).
Certain medical conditions may make the problem worse, according to Craig Schwimmer, M.D., M.P.H., ear-nose-throat surgeon and medical director of The Snoring Center in Dallas:
•Obesity can lead to excess soft tissue in the neck, narrowing the airway further.
•Acid reflux can inflame soft tissues in the throat, making them floppier.
•Nasal congestion, from allergies or colds, blocks air passage in the nose, creating an exaggerated vacuum in the throat, which pulls against floppy tissues, making them vibrate.
Also, "about half of people who snore have sleep apnea," a chronic condition where the sleeper repeatedly stops breathing, says Brian Bohner, M.D., medical director of the Sleep Disorders Center at Northwest Hospital in Randallstown, Md.
During sleep apnea, the airway briefly becomes completely blocked, and the person stops breathing for at least 10 seconds at a time. This can occur between 5-100 times an hour.
"That keeps them from getting enough air into their lungs, so oxygen can fall to dangerously low levels during the night," Bohner says.
Without sleep apnea treatment, sufferers face an increased risk of dangerous conditions, such as high blood pressure, heart rhythm problems, heart attack, stroke and diabetes.
In fact, "untreated sleep apnea doubles the risk of dying within the next five years," Bohner says.
Since you're probably more aware of your partner's breathing during the night than he is, watch for these sleep apnea warning signs:
•Loud, frequent snoring
•Pauses in breathing during sleep, sometimes followed by choking or gasping sounds
•Excessive daytime sleepiness
Whatever's causing your partner's snoring, there's a lot you both can do to improve his health and your sleep.
How to Get Him Help for Snoring:
First, discuss your partner's snoring with him. But don't be surprised if he denies it at first - many snorers don't know they're doing it and may balk at snoring remedies.
To overcome resistance, avoid being accusative, says Paul Rosenblatt, Ph.D., professor of family social science at the University of Minnesota and author of Two in a Bed (State University of New York Press). "After all, snoring isn't something he's doing voluntarily."
Instead, approach it as a mutual problem to solve together. And point out that you want to keep sharing a bed but also need to be able to get a good night's sleep.
For moderate to severe snoring, or when you suspect sleep apnea, encourage your partner to see a specialist, such as a sleep-medicine physician, otolaryngologist (ear-nose-throat doctor) or dentist.
Offer to find one or make an appointment. Your primary-care physician often can provide a referral, and the American Academy of Sleep Medicine and American Academy of Dental Sleep Medicine have searchable online directories.
The evaluation process starts with a physical exam and medical history. As the bed partner, you'll probably be encouraged to come along on the first visit.
"You're the one who can tell the doctor what's happening while the patient is asleep," Bohner says.
A portable, home-based sleep monitor may also be prescribed. But that won't provide all the information needed to make a definitive diagnosis, Bohner says.
For that, a doctor may recommend that your partner spend the night at a sleep center, where he can be monitored with sensors that track brainwaves, eye movement, muscle activity, breathing rate, blood oxygen level, heart rate and blood pressure.
Deciding on a Snoring Treatment:
The doctor may present your partner with several treatment options. Effectiveness, risk, comfort and convenience should all factor into your choice of snoring cures. As you and your spouse choose a treatment, remember insurance generally only covers sleep apnea treatment.
The decision often comes down to evaluating "several reasonable options, none of which is perfect," Schwimmer says.
Here are the most common snoring remedies:
•Oral appliances are custom-fitted dental mouthpieces that reposition the lower jaw to prevent the tongue from falling back and blocking the throat during sleep.
"An oral appliance can be very effective for snoring and mild to moderate sleep apnea," says John Comisi, D.D.S., a dentist in Ithaca, N.Y., and spokesperson for the American Academy of General Dentistry.
•Continuous positive airway pressure (CPAP) is the preferred sleep apnea treatment for severe cases. The person wears a mask over his nose while sleeping. This mask is attached to a machine that gently blows air into the throat, so the pressure holds the airway open.
Besides having to wear an uncomfortable mask, possible side effects include a dry or stuffy nose, dry mouth, irritated facial skin and headaches. The noise of a CPAP machine in the bedroom can also be a problem. Fortunately, today's machines are considerably smaller and quieter than past models - and "much quieter than snoring," Bohner says.
•Palatal implants, also known as the Pillar procedure, are small rods inserted into the soft palate to stiffen it. It stops snoring by preventing the soft palate from collapsing and obstructing the airway during sleep.
"The procedure can be done in the doctor's office in just a few minutes, and the patient can go right back to work," Schwimmer says.
•Radiofrequency tissue ablation, also known as coblation, uses radiofrequency energy to reduce and stiffen tissue in the soft palate.
The effectiveness is comparable to palatal implants, Schwimmer says. But it's also more invasive and a bit more uncomfortable.
Also, the procedure will need to be repeated in about 3-5 years.
•Traditional or laser surgery can reduce excess tissue in the palate, uvula, tonsils or nasal turbinates. Possible risks include pain, infection, bleeding and nasal congestion.
In one laser procedure, called laser-assisted uvula palatoplasty (LAUP), the uvula is removed and soft palate shortened. Done on an outpatient basis under local anesthetic, it's gentler than traditional surgery. However, it can cause pain while swallowing for several days, and multiple treatments may be needed.
Whichever snoring remedies your partner tries, your support can determine its success. One study of married men using the CPAP mask found that they were more likely to stick with it if their wives slept in the same bed.
"If the husband was sleeping alone, he was more likely to think his snoring didn't matter and go off treatment," says study researcher Rosalind Cartwright, Ph.D., professor emeritus at Rush University in Chicago and author of The Twenty-Four Hour Mind (Oxford University Press).
Making Lifestyle Changes -
Your partner's health choices can also dial down the decibel level in your bedroom - and make more drastic treatments unnecessary.
Encourage him to try these snoring remedies:
•Lose weight to stop snoring related to obesity.
•Avoid alcohol within three hours of bedtime, because alcohol relaxes throat muscles, Schwimmer says. Sedatives and sleeping pills have the same effect.
•Exercise regularly, which helps control weight. "It also promotes good overall muscle tone, which is beneficial," Schwimmer says.
•Quit smoking. "Tobacco smoke tends to inflame tissues of the upper airway," Schwimmer says. This swelling narrows airways, impeding airflow.
•Manage acid reflux by avoiding large meals within three hours of bedtime and foods that cause heartburn, Schwimmer says. Take any acid-reducing medication as prescribed.
•Treat nasal congestion. Using saline nasal spray at night may clear nasal passageways. If that doesn't work, ask your partner to talk to his doctor about other treatments, such as decongestants, antihistamines and steroid nose sprays. Nasal strips only stop snoring for about 1 in 20 people, but there's little harm in trying them, Bohner says.
•Change sleep position. Snoring is generally worse when sleeping on your back, Schwimmer says. A full-body pillow can help him maintain a side-sleeping position.
A combination of lifestyle measures and medical treatment can usually reduce even the most wall-rattling roar to a soft buzz. But it won't always stop snoring entirely. If you still can't sleep well, use earplugs, and switch on a white noise machine or fan to get the rest you need.
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