Love can be blind and, for a while, even deaf. I was somewhat aware that my husband-to-be had a snoring problem, but I didn't realize the extent until a friend he had traveled with presented us with an unusual wedding present: a black collar studded with little electrodes. Whenever my husband snored, he'd get a harmless electric shock that would wake him up — with the goal of conditioning him to stop snoring altogether. After a few nights, though, my husband called for an end to the torture, pointing out that a heart attack would permanently end the snoring. Like so many other couples, our bedtime rituals became reminiscent of Monday Night Football: swift kicks, sharp elbows, and time-outs. According to a National Sleep Foundation survey, twice as many men as women report that they snore every (or nearly every) night — 32 percent of men versus 16 percent of women. "The majority of people we see, study, and treat are men," says J. Catesby Ware, Ph.D., director of the Sleep Disorders Center at Sentara Norfolk General Hospital, and professor of medicine and psychiatry at Eastern Virgina Medical School. The majority of sufferers are women. Snoring can take a heavy toll on a relationship. A study by John Shepard, M.D., medical director of the Sleep Disorders Center at Mayo Clinic in Rochester, Minn., found that the bedmates of heavy snorers lose an average of one hour of sleep per night. Dr. Shepard calls the phenomenon of partners being awakened by snoring spousal arousal syndrome. Unfortunately, it's not the kind of arousal most people crave in bed. Another study released last year, from the National Naval Medical Center in Bethesda, Md., found that when heavy snorers with sleep apnea underwent treatment, they and their spouses reported better sex lives and a smoother relationship.
How to Tell Him
An obstruction in the airway between the nose and lungs is usually the cause. It can be swollen nasal tissue, a too-relaxed tongue, fatty deposits in the throat, or a large uvula (that kidney-shaped object hanging at the back of the mouth). Snoring tends to get worse as people age because, like so many other body parts, tissues in and around the airway start to sag. The mid-40s and up is when snoring really becomes more prevalent, Ware says.
The first hurdle in dealing with snorers is to get them to acknowledge the problem. There's usually very little perception of snoring on the part of the snorer, says Victor Hoffstein, M.D., director of Toronto's Sleep, Nose, and Sinus Clinic at St. Michael's Hospital, and coauthor of No More Snoring. A man may not believe his wife, Ware says, but he'll believe his hunting buddies when they won't sleep in the same cabin with him. I personally discovered that a tape recorder did the trick. Tempting as it may be for a wife to withdraw to the guest room, Dr. Hoffstein says, that's focusing on the symptom, not the root of the problem.Examine His Habits
If you live with a chronic snorer, take a hard look at his habits. Some simple changes could stop the problem for good. The vast majority of snorers can be treated with a lifestyle solution, Dr. Hoffstein says.Is he overweight? Being overweight is the most common cause of snoring, Dr. Hoffstein explains. A person who gains weight usually has excess fat deposits in the neck. The fat deposits increase the collapsibility of the throat tissue and can narrow the airway. Once men hit a shirt size of 17, they are candidates for weight-related snoring. Sometimes a weight loss of as little as 10 pounds can help.Does he drink alcohol before going to sleep? If your bedmate is having a couple of nightcaps, it may be relaxing the muscle tissue in his throat and causing the tongue to drop back more. Don't drink alcohol less than four hours before bedtime, recommends Daniel Loube, M.D., director of the Sleep Disorders Center at Virginia Mason Medical Center in Seattle. Some medications, such as sleeping pills and tranquilizers, produce the same relaxing effect.Does he sleep on his back? If he does, his jaw may open, causing the tongue to shift closer to the back wall of his throat, which narrows the airway. Elevating the head can help up to thirty percent of snorers, Dr. Hoffstein says. Another solution is to make him sleep on his side. One low-tech strategy: Sew a sock containing a tennis ball onto the back of his pajama top so that when he turns on his back, he'll wake up and change his position.Does he smoke? Cigarettes irritate and inflame the upper airways, making them narrow. Snoring is just one more reason to try to get him to quit.Possible Causes of Snoring
Does he have a cold or allergy? If so, the snoring is probably originating in the nose. If he has a cold, he can use nasal decongestants on a short-term basis. But if he has an allergy, it needs to be diagnosed and treated.Is there an anatomical abnormality? These can range from a deviated septum to extra tissue in the neck. If you suspect such a problem, it's time to talk to your doctor about a sleep study or polysomnogram, which involves a one-night test at a sleep center (average cost: $1,200, usually covered by health insurance). During the sleep study, instruments measure heart, lung, and brain activity; breathing patterns; arm and leg movements; blood-oxygen levels; and how often the patient awakens during the night. The study can determine the origin and severity of the snoring. Depending on the cause, there are a number of surgical procedures that can be done. The downside of surgery is that it can be very painful — and there's no guarantee that it will work in all cases, says Ron Kuppersmith, M.D., a surgeon at Virginia Mason Medical Center. The various procedures, often done on an outpatient basis, tend to cost between $1,500 and $2,500, and are covered by insurance if there is an underlying medical problem. Another possible solution is a mouth device that moves the lower jaw forward, thereby opening up the airway. The device can be fitted by a specially trained dentist and costs about $1,000.Could It Be Dangerous?
Does he snort and gasp in his sleep, then feel tired all day? When a person has loud-intensity snoring, it is an alarm signal, Dr. Loube says. It is important to distinguish between benign snoring and a dangerous condition called sleep apnea.A person with sleep apnea stops breathing for 10 seconds or longer several times every hour, all night long. As respiration is cut off, and the level of oxygen in the blood drops, he wakes up briefly to reopen his airway, then resumes breathing with a snort. When you go from being fast asleep to suddenly awake, it's very stressful on the body, Dr. Kuppersmith says. According to the National Center on Sleep Disorders Research, up to half of all people with sleep apnea have high blood pressure, which raises the risk of stroke and heart failure. The majority also suffer from daytime drowsiness and are more likely to have car accidents than people without the condition. One explanation of why married men live longer than single men is that their wives discover the sleep apnea problem and get them care, Ware says.
Sleep apnea can be addressed with oral devices and surgery, but continuous positive airway pressure (CPAP) is usually the first medical treatment used. It involves wearing a mask or special mouthpiece while sleeping; a blower gently forces air through the nasal passages. If the snorer can tolerate sleeping with the apparatus, CPAP is highly effective. Because apnea is a medical condition, most insurers will pay the estimated $400 to $1,200 cost for CPAP.
Fortunately, I haven't yet had to sleep with a masked man. My husband's snoring has improved over the years without such dramatic measures. He stopped smoking and lost some weight. After he drinks red wine, he sleeps in another room. And I do have my own secret weapon: a little white-noise machine. When the snoring starts, I just submerge myself in the soothing sounds of a waterfall.
Sleep Apnea
Not everyone who snores has sleep apnea, but almost no one has sleep apnea without loud snoring. Data from the Wisconsin Sleep Cohort Study suggests that 12 million Americans suffer from sleep apnea, a potentially life-threatening condition that temporarily cuts off respiration. How do you tell the difference between benign snoring and apnea? Wake up and listen! If your partner snores, watch to see if he actually stops breathing, says Ron Kuppersmith, M.D., a surgeon at Seattle's Virginia Mason Medical Center. If he's totally quiet and the chest is not moving, count the seconds. The next morning, most people with sleep apnea can recall hearing themselves snore. Some feel short of breath for a brief period. Here are the symptoms:Finding Help
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