About the Causes and Consequences of Sleep Apnea
Interview with Dr. Albrecht Vorster - Director of the Swiss Sleep House Bern
Dear Dr. Vorster, approximately 1.5 million people in Switzerland snore at night. In this context, we also hear about so-called sleep apnea, that is, pauses in breathing during snoring. How long can these last, and what effects do they have?
The pauses in breathing can last between 10 and 30 seconds. Sometimes even longer, which often frightens the person sharing the bed. The greater a patient’s pre-existing conditions due to heart or lung disease, the more the body suffers.
You should take notice if your sleep duration is within the normal range, but you wake up in the morning feeling exhausted rather than refreshed. Daytime sleep attacks become more frequent, and you lose concentration, which significantly increases both the error rate and the accident rate at work and on the road.
It is important to note how often such episodes occur during the night, as frequent awakenings severely disrupt nighttime sleep. As a result, important regenerative processes cannot be completed. There is even a link between apnea and an increased risk of dementia. Vascular dementia is triggered by a diseased cardiovascular system. Additionally, the risk of high blood pressure and elevated cholesterol levels increases.
Are there people who are particularly prone to snoring or apnea?
The more overweight a person is, the greater the likelihood of snoring. Fat takes up a lot of space in the body, and the respiratory and throat muscles suffer as a result. If people with a BMI over 25 reduce their body weight by 10 kg, breathing pauses are reduced by half.
40% of patients with high blood pressure suffer from sleep apnea. If this is treated successfully, one can avoid taking high blood pressure medication. We also tend to snore more as we age because the muscle and tissue tone in our throats decreases. Here, good results can be achieved with targeted throat muscle training, for example using a didgeridoo or speech therapy exercises.
What else influences snoring?
Major triggers include sleep aids and alcohol. Sleep aids are essentially muscle relaxants, so they also relax our throat muscles. It is noteworthy that two-thirds of all sleep aids are prescribed to women over 65. Additionally, studies show that alcohol consumption increases in retirement age. Seniors over 65 drink, on average, twice as much alcohol as 25-year-olds. This can be explained by the fact that social drinking increases—people treat themselves to “a glass” more often—while at the same time, regular exercise is often lacking and muscle tone decreases significantly.
From an anatomical perspective, the following risk factors also exist: enlarged tonsils, an oversized tongue that narrows the airway, smoking, and stress.
How would you estimate the importance of proper sleeping position in improving sleep apnea?
About 50% of people with sleep apnea can be helped by adjusting their sleeping position. Snoring occurs particularly when lying on the back. It’s best to get used to sleeping in a relaxed side position. If you still prefer sleeping on your back, it’s best to choose a firmer mattress so that your chest doesn’t sink in too much and narrow the airways. We also recommend elevating the upper body. This can be achieved by placing a 10-cm wedge under the slatted frame or using a motorized adjustment feature. This also provides relief for heartburn and acid reflux.
Finally, we would like to know what effect nasal breathing has on snoring.
The common practice of mouth breathing contributes significantly to snoring. The throat dries out, which promotes snoring. Through the so-called triple closure of the mouth (lips, palate, and jaw), the nose takes over breathing. This nasal breathing not only cleanses, warms, and humidifies the inhaled air but also strengthens our diaphragm. The respiratory muscles are automatically stimulated in a positive way.
Thank you very much for all the fascinating insights from your perspective as a sleep medicine specialist!