What are the symptoms of snoring with sleep apnea?  When excessive tissues in the throat relax during sleep, air passing through vibrates these tissues to produce snoring. When these tissues collapse in some heavy snorers, there may be increased resistance to or decrease in flow of air, or stopping of breathing. This is called sleep apnea. With each breathing disturbance the heart slows, blood pressure rises, blood and brain oxygen drop, and irregular heart beats may occur. Then an awakening may occur, usually too short to remember, and normal breathing resumes. Mild sleep apnea affects 24% of men and 9% of women, and may cause daytime sleepiness in about a fifth of these patients. Moderate to severe sleep apnea affects 9% of men and 4% of women, and causes a significant increase in the risk of high blood pressure, heart attacks, strokes and sudden death.

How is it treated? Moderate to severe sleep apnea is potentially life threatening, and should be treated aggressively. Severe sleep apnea is best treated with CPAP, a device that pumps air into the airway and inflates it. CPAP always works, controls the sleepiness and prevents the deaths associated with severe sleep apnea. Surgery on the palate and uvula is usually not sufficient, but additional surgery to cut and move forward both jaws works. When apnea is mild to moderate, options include CPAP, palate surgery, or a mouth device. Mild sleep apnea should definitely be treated if it causes sleepiness. In the absence of sleepiness, treatment for mild sleep apnea is optional, since it is a social problem more than a medical problem. In children, CPAP can be used, or tonsillectomy might help.

When should I seek help? If snoring is accompanied by sleepiness, or someone has noticed you stopping breathing in sleep, you probably have sleep apnea. It is very important to have this evaluated, and, if necessary, treated. When there is snoring without sleepiness or stopping breathing in sleep, medical evaluation and testing is not always necessary.