Sometimes I snore like a steam shovel, other times more like a teakettle. This "gentle, unromantic music of the nose," as William Makepeace Thackeray called it, is the nighttime soundtrack in many homes. For most of us, snoring is no more than an irritant to those trying to sleep within range. But for 12 million American men, the cause of snoring is an invisible, though not-so-silent, epidemic -- obstructive sleep apnea, a cessation of breathing during sleep.
We snore -- about half of adult men snore, according to studies -- for one of two reasons. Mostly we snore because our airways narrow in sleep, creating resistance in the passageways that connect our nose and mouth to the lungs. The narrower the tube, the greater amount of pressure needed to establish enough flow. The fatter we are -- and in particular, the thicker our necks -- the more pressure there is on the airways, and the more they tend to collapse as we sleep.
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A small percentage of men have a structural problem, a small jaw or a "shallow midface" -- the area between your nostrils and the back of your head -- which can cause snoring even in thin men. In either case, the more suction pressure on the soft tissues of the mouth, the more vibration and the more snoring.
"If there's enough pressure, you collapse the airway and obstruct it," explains Patrick Strollo, MD, assistant professor of medicine at the University of Pittsburgh. An obstructed airway means your lungs aren't getting enough oxygen. If your blood oxygen level plummets when your airway is blocked, a message is sent to your brain to wake you up so you can breath again.
Sleep is a foreign country to the sleeper. You can't see yourself sleep, or hear yourself snore. The typical apneic -- a person with apnea -- will wake up dozens or even hundreds of times each night without knowing it.
"Usually it's the wife or girlfriend who brings them in, horrified by what they see when these men are asleep," says Nancy Collop, MD, a pulmonologist and director of the sleep clinic at Johns Hopkins University Hospital in Baltimore. "The patients themselves are often unaware of sleep apnea -- it's pretty unusual for a patient to wake up complaining of not breathing. All they realize is that no matter how much they sleep, they can't get good sleep."