To diagnose this, a polysomnography (sleep test) is required. Based on the Apnea-Hypopnea Index (AHI) obtained from this test, sleep-related breathing disorders are categorized into three types:
- Simple snoring
- Upper airway resistance syndrome (UARS)
- Obstructive sleep apnea syndrome (OSAS)
SIMPLE SNORING
If the AHI is below 5, oxygen saturation during sleep is above 90%, and the pressure in the esophagus during inhalation does not fall below -10 cm H₂O, the condition is considered simple snoring.
SIMPLE SNORING
- An AHI of 5–20 indicates mild apnea,
- 20–40 indicates moderate,
- Above 40 indicates severe apnea.
WHO IS AFFECTED?
What’s often assumed to be just snoring can actually be a mild form of sleep apnea. Among men under 30, the prevalence is around 30%, and this rises to 60% in men over 60. There is a direct correlation between body weight and snoring. Overweight individuals are more likely to experience both snoring and sleep apnea.
Mild sleep apnea is more common, while moderate and severe cases are less frequently seen. Moderate obstructive sleep apnea is observed in approximately 2% of adult men, while severe apnea is seen in only 0.3% of men aged 35–60.
TREATMENT OF SNORING AND SLEEP APNEA
Treatment varies depending on the severity of the condition and the location of the airway obstruction. Non-surgical options include:
- Lifestyle modifications
- Medication
- Pressurized air masks (CPAP)
- Oral appliances
LIFESTYLE CHANGES
Most people with snoring or sleep apnea are overweight. Excess weight contributes to sleep apnea, and sleep apnea, in turn, lowers oxygen intake and slows metabolism, increasing fatigue and leading to further weight gain. Therefore, achieving ideal body weight is a key goal.
Smoking, sedatives, and alcohol worsen sleep apnea and should be avoided.
Sleeping on the back is not recommended. Side-sleeping is the ideal position.
If nasal congestion is present, the underlying cause should be diagnosed and treated.
Other underlying medical conditions, such as hypothyroidism, should be identified and managed, as they can contribute to sleep apnea.
POSITIVE AIRWAY PRESSURE DEVICES (CPAP)
The CPAP (Continuous Positive Airway Pressure) device is one of the most effective non-surgical treatments for sleep apnea. It works by providing continuous air pressure to keep the airway open during sleep, counteracting the collapse caused by negative pressure.
CPAP is suitable for:
- Patients who refuse or are not eligible for surgery
- Patients who do not benefit adequately from surgery
- Pre-surgical preparation
ORAL APPLIANCES
There are two main types of oral appliances:
- Devices that pull the tongue forward
- Devices that advance the lower jaw
More than 75% of simple snorers see improvement with these devices. However, side effects such as increased saliva or dry mouth are common. Long-term use may lead to jaw joint issues.
SURGICAL TREATMENT OF SNORING AND SLEEP APNEA
Surgery is planned according to the underlying cause. For example:
- If nasal obstruction is the cause, septoplasty or turbinate reduction may be necessary.
- If enlarged tonsils or a long uvula contribute to the problem, surgery may target these areas.
- Additional options include operations involving the soft palate, tongue base, or even the jaw.
