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How to Stop a Snoring Man

Half of adult men snore. Here are the common causes and cures.

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Not everyone who snores is apneic, says Strollo, who is also the chief of the sleep medicine laboratory at the University of Pittsburgh. But there's a continuum between snoring and apnea, and if you snore for enough years, you can become apneic. Sleep specialists define apnea by the number of times a person wakes per hour -- five is often the number given -- but also by the degree of daytime sleepiness.

Although good sleep is probably as important as good diet and exercise to overall health, it's a latecomer to medicine. In 1956, C.S. Burwell, MD, characterized sleep apnea as the "Pickwickian Syndrome" in honor of Joe, the Fat Boy, a character in Dickens's Pickwick Papers who "goes on errands fast asleep, and snores as he waits at table."

Doctors didn't get into the business of diagnosing the condition until the 1970s. Even now, only about 10% of primary physicians ask questions about sleep, and as a result, an estimated 90% of sleep apnea goes undiagnosed and untreated.

The typical sleep apnea patient is an overweight, middle-aged man. Among men with a more healthy physique, sleep apnea seems to occur disproportionately in people of Asian descent, possibly because of the shape of their faces, according to Collop.

Luckily, there is an effective therapy for sleep apnea. Unluckily, it's a rather ungainly apparatus that makes the wearer look like a brain-damaged hospital patient. It's called CPAP, for continuous positive airway pressure, and it consists of an air hose attached to a mask that's fastened around the head and blows air through the nose.

The device was introduced in 1981 and remains the standard of care for treating breathing problems during sleep. "I can almost guarantee that CPAP will cure almost anybody with sleep apnea -- if they wear it," says Collop. "They feel better usually the first night, and within two or three weeks they've shaken off sleep deprivation. The problem is to get people to wear it consistently."

Improvements of the sleep apnea machine have made the generator smaller and quieter, able to vary the air pressure depending on the patient's breathing patterns, and able to humidify the air to prevent dehydration in the airway. Currently, the device is about the size of half a loaf of bread, and can easily be taken on trips. Chin straps keep the mask in place during sleep (although they also make it look like you're wearing a bandage that holds your head together). In studies, compliance ranges from 50% to 60%.

Additional treatments for snoring and sleep apnea include weight loss, antihistamines to clear the sinuses, nasal dilators, and avoidance of alcohol at night. Snorers are also encouraged to change their sleep posture to avoid lying on their backs. Sometimes doctors recommend a variety of oral appliances, similar to an orthodontic retainer, which may improve airway pressure.

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