How Can I Find Out if My Snoring Is Sleep Apnea or Something Else That's Serious?

A fellow caregiver asked...

How can I find out if my bed partner's complaints about my snoring point to something serious, like sleep apnea?

Expert Answer

Craig Schwimmer, MD, MPH, is a board-certified otolaryngologist, a head and neck surgeon who focuses on snoring and sleep apnea. He is the medical director of the Snoring Center, a leading provider of minimally invasive treatment for sleep-disordered breathing, located in Dallas.

Start by asking him or her if your snoring is very loud and erratic; that's the most common clue to what's called obstructive sleep apnea. People with sleep apnea tend to snore loudly and make a characteristic snorting sound, as if they're catching their breath. Another clue: People with sleep apnea tend to be tired during the day, because they don't get restorative sleep.

Simple snoring itself, though, is usually not a medical concern; half of all adults snore. Sleep apnea refers to a disease where the soft tissue in the throat not only vibrates (making snoring noises) but actually blocks airflow, denying your body the oxygen it needs.

If you suspect sleep apnea, you'll want to get a clear diagnosis. The way that's done is with a sleep study that records your breathing and oxygen levels; if you stop breathing for intervals longer than ten seconds more than five times per hour, you have obstructive sleep apnea. What's interesting is that even if you stop breathing 25 times an hour for nine seconds, you wouldn't meet the definition of sleep apnea. Instead, that would likely be defined as Upper Airway Resistance Syndrome (UARS), which is another type of sleep-related disordered breathing, and it would also require treatment.

Sleep apnea becomes much more common in older adults because our muscles relax and weaken as we age; that includes the muscles of the mouth, tongue, and throat. Gaining weight also puts you at risk for sleep apnea, and many medications can contribute to the condition as well, particularly any type of sedative. Sedating antihistamines for allergies, such as Benadryl, and sedating antidepressants are two of the main culprits.

Another huge contributing factor is alcohol. While we may think of a late-night drink as a "nightcap," drinking before bed can actually contribute to snoring and apnea. Alcohol is a huge factor because it relaxes the muscles, including those of the throat.

So the first strategies to try are those that eliminate the risk factors for apnea:

  • Don't drink in the evening.

  • Lose excess weight.

  • Switch to a nonsedating antihistamine such as Claritin if you have allergies.

  • Ask your doctor about switching to a nonsedating antidepressant.

However, if you have moderate to severe sleep apnea, these techniques are unlikely to be enough to treat it, and you'll want to see an ear, nose, and throat specialist for treatment. (Apnea sufferers shouldn't even bother with OTC aids such as snore strips and nasal sprays.)

The doctor may have you do a sleep study to measure and record your oxygen levels during sleep. These studies can either be done in sleep labs or in your own home.