Several factors increase your chances for sleep apnea— from weight gain to excess throat tissue. Most sleep-apnea sufferers exhibit more than one cause, so you have to address them all to find the right cure.
Many doctors first try to treat the condition with dental appliances, such as a mouth guard–like device that holds the jaw forward, or a retainer that prevents the tongue from flopping back. Two problems: The devices address only one factor (such as a large tongue), limiting the effectiveness; and people find the devices uncomfortable, so nearly half stop using them. The same goes for continuous positive airway pressure (CPAP), which uses a nose mask to deliver pressurized air into the airway, preventing it from collapsing. CPAP is almost always effective, says Pascualy, but it can cause dry or stuffy nose, headaches, and trouble sleeping, which is why less than 50 percent of patients continue use.
Another conventional remedy is surgery to cut away oversized tissues like the soft palate. But the problem there, says Walter Fong, DC, a chiropractor in Laguna Beach, California, and author of SnorØ Terminator: Your Deadly Snoring/Sleep Apnea (MWP Media, 2009), is that it only addresses one cause, making it marginally effective.
The Causes of Sleep Apnea
1. Extra Pounds. More than 50 percent of people with sleep apnea are also overweight. “Fat deposits on the throat change the airway’s shape,” says Ralph Pascualy, MD. “It goes from being circular to ovoid, which is structurally weaker and collapses more easily under weight or when the muscles relax.”
2. Nasal Obstruction. Being chronically congested (think allergies) makes it harder for air to pass into the throat, aggravating apnea. A deviated septum or small sinuses also can hamper breathing.
3. Tongue-Nerve Problems. The hypoglossal nerve is the main nerve controlling tongue movement. If it doesn’t fire properly—for example, because of diabetic neuropathy (nerve damage from high blood-sugar levels)—the tongue relaxes too much and blocks the throat, Pascualy says. Only specific medical tests can measure nerve function.
4. Excess Mouth and Throat Tissue. If you inherited a large tongue, large tonsils, or a fleshier soft palate (the roof at the back of the mouth), they can obstruct the airway at night. Self-evaluation is tricky (how large is too large?), so get a doctor’s opinion.
5. Small Jaw. If you were born with a small jaw (again, your doc can determine this), you might have insufficient space for your tongue, which can then block your throat.
How to tell if your significant other has sleep apnea
A spouse or partner is usually the first person to “diagnose” sleep apnea, since he or she is the one kept (frustratingly) awake by it. If you notice any of the signs below, encourage your significant other to see a doctor, for the sake of his health and your sanity.
- Loud and chronic snoring
- Pauses in breathing (typically lasting 10 to 20 seconds)
- Gasps, snorts, or choking sounds (usually following the pauses)
Note: If your spouse snores and doesn’t have apnea, you still may want to seek treatment. Since snoring results from a partially obstructed airway, the snorer isn’t getting optimal amounts of oxygen. Also, serious snoring can be a precursor to sleep apnea.