Snoring, choking and gasping in sleep
Snoring is a harsh sound that occurs when air flows through a narrow airway, causing muscles and soft tissue to vibrate. It becomes problematic when it disturbs your partner’s sleep. It can also be a source of embarrassment, especially during travel on train, or when sharing a room during travel. 87% of people who snore regularly may have Obstructive Sleep Apnea (OSA)
What is Obstructive Sleep Apnea (OSA)?
OSA is a serious disorder. Your breathing stops due to blockage of the airflow in your sleep. This occurs multiple times at night, causing reduced airflow to your lungs, resulting in a reduction of your blood oxygen saturation. When this happens, your sleep is disrupted so you can wake up and breathe again.
What causes OSA?
Why does this happen?
People with narrow airways and fat tissue in the airway (seen in overweight and obese people) are at high risk of OSA. During sleep, the airway muscles relax and tissue of the soft palate may collapse, blocking the airway.
What are the symptoms of sleep apnea?
- Loud snoring
- Disturbed sleep
- Choking or gasping for air at night
- Waking up to use bathroom at night
- Dry mouth on waking up
- Daytime sleepiness
- Bed partner may report that you stopped breathing at night
How is OSA diagnosed? (Please see sleep study)
How is Snoring/ OSA treated?
Snoring without OSA, does not require treatment, unless it embarrasses or bothers you or your spouse/ family. Here are tips to reduce your snoring:
- 1. If you are overweight or obese: lose weight.
- 2. Sleep on your side. (tongue falls back in throat when you lie on your back causing increase in snoring). Use a large pillow or wear a tee shirt with tennis ball stitched on back when you sleep to keep you off your back.
- 3. Raise the head of your bed by 4 inches or more.
- 4. Apply nasal strips (https://www.breatheright.com/how-to-breathe-better/how-breathe-right-nasal-strips-work.html) across the skin of your nostrils to open your nasal passages, so you can breathe better.
- 5. Treat nasal congestion, which may cause you to breathe through mouth, increasing the chance of snoring. Jelneti (link to Jelneti) and nasal steroid drops may help you breathe more freely through your nose.
- 6. Limit or avoid alcohol 2 hours before bedtime which is a strong relaxant of throat muscles.
- 7. Quit smoking
What are the complications of untreated OSA?
Left untreated, OSA can have serious and life threatening consequences.
Hypertension, heart disease, arrhythmias (irregular heart rhythm) and stroke. People with severe sleep apnea, are more likely to have a heart attack or sudden cardiac death at night.
Diabetics may develop poor sugar control at night and Epileptics may have increased seizures at night.
Glaucoma, depression and other ailments.
Automobile accidents due to daytime sleepiness.
Poor concentration leading to poor work and school performance.
Children with sleep apnea may be more irritable and have behavioral problems.
Sleep-deprived spouse when your snoring effects their sleep.
How is Snoring/ OSA treated?
Snoring without OSA, does not require treatment, unless it embarrasses or bothers you or your spouse/ family. Here are tips to reduce your snoring:
- 1. If you are overweight or obese: lose weight.
- 2. Sleep on your side. (tongue falls back in throat when you lie on your back causing increase in snoring). Use a large pillow or wear a tee shirt with tennis ball stitched on back when you sleep to keep you off your back.
- 3. Raise the head of your bed by 4 inches or more.
- 4. Apply nasal strips (https://www.breatheright.com/how-to-breathe-better/how-breathe-right-nasal-strips-work.html) across the skin of your nostrils to open your nasal passages, so you can breathe better.
- 5. Treat nasal congestion, which may cause you to breathe through mouth, increasing the chance of snoring. Jelneti (link to Jelneti) and nasal steroid drops may help you breathe more freely through your nose.
- 6. Limit or avoid alcohol 2 hours before bedtime which is a strong relaxant of throat muscles.
- 7. Quit smoking
Treatment of OSA
Nasal CPAP (continuous positive airway pressure) generates positive air pressure which is connected by a hose to a mask which patient wears. This flow of air to the throat will prevent the airway from collapsing. For more information: https://www.sleep.org/articles/what-is-cpap-machine/.
CPAP is the gold standard treatment for people with moderate to severe OSA. Some people may have hypoventilation [shallow breathing resulting in reduced air entering air sacs (alveoli) of lungs]. This is seen in people with pulmonary (lung) or neuromuscular problems. In these conditions, treatment with a Bi-level machine (higher pressure during inspiration than expiration) is required. There are different types of Bi-level machines.
Our AMARA Sleep team is experienced with both basic and complex titrations for OSA and other breathing problems.
For people with isolated snoring or mild OSA, other treatment options are:
Oral appliances
These devices look like a mouth guard. They are worn during sleep to move the tongue and lower jaw forward and upwards. This will increase size of the upper airway, helping you breathe better. Oral appliances are fitted by dentists trained in sleep medicine. They are used to help patients with mild to moderate OSA, and when CPAP therapy is not tolerated.
Upper airway surgery
Surgery may be indicated if you have facial abnormalities that contribute to OSA. Surgical options will depend on each individual’s upper airway anatomy.
For severely overweight or obese patients, bariatric surgery may also be considered as part of the treatment strategy for OSA. Weight loss after this surgery will help improve OSA symptoms.
Snoring is a harsh sound that occurs when air flows through a narrow airway, causing muscles and soft tissue to vibrate. It becomes problematic when it disturbs your partner’s sleep. It can also be a source of embarrassment, especially during travel on train, or when sharing a room during travel. 87% of people who snore regularly may have Obstructive Sleep Apnea (OSA)
What is Obstructive Sleep Apnea (OSA)?
OSA is a serious disorder. Your breathing stops due to blockage of the airflow in your sleep. This occurs multiple times at night, causing reduced airflow to your lungs, resulting in a reduction of your blood oxygen saturation. When this happens, your sleep is disrupted so you can wake up and breathe again.
What causes OSA?
Why does this happen?
People with narrow airways and fat tissue in the airway (seen in overweight and obese people) are at high risk of OSA. During sleep, the airway muscles relax and tissue of the soft palate may collapse, blocking the airway.
What are the symptoms of sleep apnea?
Loud snoring
Disturbed sleep
Choking or gasping for air at night
Waking up to use bathroom at night
Dry mouth on waking up
Daytime sleepiness
Bed partner may report that you stopped breathing at night
How is OSA diagnosed? (Link to sleep study)
What are the complications of untreated OSA?
Left untreated, OSA can have serious and life threatening consequences.
Hypertension, heart disease, arrhythmias (irregular heart rhythm) and stroke. People with severe sleep apnea, are more likely to have a heart attack or sudden cardiac death at night.
Diabetics may develop poor sugar control at night and Epileptics may have increased seizures at night.
Glaucoma, depression and other ailments.
Automobile accidents due to daytime sleepiness.
Poor concentration leading to poor work and school performance.
Children with sleep apnea may be more irritable and have behavioral problems.
Sleep-deprived spouse when your snoring effects their sleep.
How is Snoring/ OSA treated?
Snoring without OSA, does not require treatment, unless it embarrasses or bothers you or your spouse/ family. Here are tips to reduce your snoring:
- 1. If you are overweight or obese: lose weight.
- 2. Sleep on your side. (tongue falls back in throat when you lie on your back causing increase in snoring). Use a large pillow or wear a tee shirt with tennis ball stitched on back when you sleep to keep you off your back.
- 3. Raise the head of your bed by 4 inches or more.
- 4. Apply nasal strips (https://www.breatheright.com/how-to-breathe-better/how-breathe-right-nasal-strips-work.html) across the skin of your nostrils to open your nasal passages, so you can breathe better.
- 5. Treat nasal congestion, which may cause you to breathe through mouth, increasing the chance of snoring. Jelneti (link to Jelneti) and nasal steroid drops may help you breathe more freely through your nose.
- 6. Limit or avoid alcohol 2 hours before bedtime which is a strong relaxant of throat muscles.
- 7. Quit smoking
Treatment of OSA
Nasal CPAP (continuous positive airway pressure) generates positive air pressure which is connected by a hose to a mask which patient wears. This flow of air to the throat will prevent the airway from collapsing. For more information: https://www.sleep.org/articles/what-is-cpap-machine/.
CPAP is the gold standard treatment for people with moderate to severe OSA. Some people may have hypoventilation [shallow breathing resulting in reduced air entering air sacs (alveoli) of lungs]. This is seen in people with pulmonary (lung) or neuromuscular problems. In these conditions, treatment with a Bi-level machine (higher pressure during inspiration than expiration) is required. There are different types of Bi-level machines.
Our AMARA Sleep team is experienced with both basic and complex titrations for OSA and other breathing problems.
For people with isolated snoring or mild OSA, other treatment options are:
Oral appliances
These devices look like a mouth guard. They are worn during sleep to move the tongue and lower jaw forward and upwards. This will increase size of the upper airway, helping you breathe better. Oral appliances are fitted by dentists trained in sleep medicine. They are used to help patients with mild to moderate OSA, and when CPAP therapy is not tolerated.
Upper airway surgery
Surgery may be indicated if you have facial abnormalities that contribute to OSA. Surgical options will depend on each individual’s upper airway anatomy.
For severely overweight or obese patients, bariatric surgery may also be considered as part of the treatment strategy for OSA. Weight loss after this surgery will help improve OSA symptoms.
