What is snoring and what causes it?
What causes snoring?
"The most common respiratory condition is actually obstructive sleep apnea and snoring is one of the main symptoms. A lot of the patients that I see, that is one of the main reasons that they've actually come to the hospital," says Garvey. It's not uncommon to snore if you've got a head cold, allergies, tonsillitis, or if you're pregnant, for example. Perimenopause and menopause are also a factor and make obstructive sleep apnea more common for women. Weight gain, alcohol consumption and smoking can all have an impact on snoring as well. "All of these factors come into play," he says.
What is snoring?
"Snoring is actually turbulence of air flow, you're generating noise in the upper airway. So anything that affects the upper airway and makes the tissues there floppier, or if there's scaring, or if there's collapsibility of any part of the upper airway, you get turbulence of air flow and that just manifests as noise," Garvey explains. "For some people it only happens when they lie on their back because the jaw hinges in that way."
From RTÉ Radio 1's Drivetime, Helen Vaughan, Counsellor at Maynooth Counselling and Psychotherapy, on what to do if snoring is effect your relationship
What drives people to seek help?
Sometimes they or their partner are worried. "Patients may find themselves on the couch or in the spare room, and that may drive them [to seek help]. But for others, if their partner is distressed, their quality of life is affected by the snoring, and they're keen for a resolution to this, and might seek help because pushing the partner over on their side doesn't work anymore," he says. "They may seek medical advice then."
What is driving increased numbers of people with obstructive sleep apnea?
"The biggest driver is obesity. Over the past few decades we've had a huge surge in obesity as a disease, so a large proportion of our population have obesity and that's impacting on the number of patients that are being referred to us now with obstructive sleep apnea." Age also has an impact and there's also an association with cardiovascular disease, says Garvey.
"Untreated obstructive sleep apnea is a risk factor for cardiovascular disease. So it's not uncommon for people, if they're newly diagnosed with high blood pressure, if they're not dipping their blood pressure at night, on a 24 hour blood pressure monitor with their GP, the GP might often send a referral to a sleep laboratory for assessment."
How reliable is wearable tech?
"Wearable tech has improved a lot. The Apple Watch and the Samsung watch in the last year have been approved by the FDA to give people alerts. I've even seen patients this week who have come in and said that their Apple Watch has said that you possibly have obstructive sleep apnea. Now, those watches can miss obstructive sleep apnea, so they're not completely sensitive to the condition. But if they're telling you that you have obstructive sleep apnea, they're pretty accurate."
When should you seek help?
"If basic lifestyle measures like avoiding smoking, cutting back on alcohol, watching your weight, aren't helping, If sleeping on your side isn't enough, if you're disturbing your partner, or if you've got other health concerns, that you're feeling tired all the time, if you've got new cardiovascular problems and you have a concern that this could be related to obstructive sleep apnea, then that's the time to actually seek help."
Do you have to sleep overnight at the hospital?
"The technology that we use has changed. The gold standard is still to spend the night in hospital and have what we call full polysomnography," Garvey says. "Where you're having a brain tracing, and your eye movements are being looked at. So you can tell if somebody's asleep, what stage of sleep, that is the gold standard. But we now can give patients devices to take home with them to wear, we also have medical grade wearable technology in this space, that you connect with your phone via Bluetooth. So the diagnostic element is moving closer to patients all the time."
Are drugs like Wegovy and Ozempic impacting levels of obstructive sleep apnea?
"Absolutely. So I've actually seen patients use these drugs because they've had diabetes or they've engaged in studies that have been run in my hospital over the past seven or eight years." Tirzepatide, a drug made by American company Eli Lilly, has recently been licensed in the US for treatment of obstructive sleep apnea associated with obesity. "So we know these drugs work to help people to manage their obesity. Obstructive sleep apnea for many people is a complication of their obesity."
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