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Sleep Disorders

Timing of sleep

12/11/2007

Question:

My fiance and family say I snore. This is true. I have awakend myself. My question is, while at work I have a 15 minute break. I can fall asleep and will be snoring within that short amount of time. Please assist.

Answer:

I assume you are asking about why you might be snoring and are sleepy and what this might mean. These symptoms, snoring and excessive sleepiness, are common and can be due to multiple causes. While it's possible you may be a simple snorer who is sleepy for a different reason (i.e. lack of adequate sleep), the main issue is whether or not you might have obstructive sleep apnea (OSA) as loud snoring and excessive sleepiness are the hallmark symptoms of this condition. I'll discuss OSA in general and attempt to speak to the particulars of your case as we go.

OSA is a common condition, affecting roughly 5% of middle aged adults in America. Most individuals with this condition are still not diagnosed and, of those that are diagnosed, many have had it for many years prior to undergoing appropriate testing.

OSA is a condition where the airway partially or completely collapses during sleep. This results in fragmentation of sleep and, in some individuals, low oxygen level during sleep. The consequences of this condition can be serious and range from a poor quality of life (morning headaches, disabling sleepiness, poor concentration, irritability, etc) to increasing problems with blood pressure control, heart disease and strokes. Symptoms may include waking up choking or gasping at night, very loud snoring (as you describe), poor and unrefreshing sleep, morning headaches and daytime sleepiness (again, as you describe). The risk factors for sleep apnea include obesity and craniofacial abnormalities. With the symptoms you describe, if you are overweight or have a crowded upper airway (such as from enlarged tonsils or a large tongue or a crooked nose), then it's likely that you could have OSA.

As mentioned above, most patients with OSA have had it for several years by the time they are diagnosed. The diagnosis requires some form of objective monitoring of sleep, typically done by an in-lab sleep study. Some sleep centers offer limited channel home sleep studies, though there is controversy about whether these studies are accurate enough for routine use and not all third party payers will acknowledge or pay for these types of studies. Without objective testing (a sleep study), there is no way to tell with certainty, based on historical information, if you have OSA or not.

It would probably be a good idea to discuss your case with your primary doctor. Referral to a Sleep Specialist in your area would be useful. They can review your records as well as your history / exam and determine if additional testing is needed and if so, what method of testing would be best for you. I recommend seeing a Sleep Specialist that is board certified and working at an accredited Sleep Center.

To learn more about sleep apnea or other sleep disorders, please visit the American Academy of Sleep Medicine website. In addition to information, the website contains a list of Sleep Centers across the country so that you may locate one near you. Good luck and here's to good sleep!

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Response by:

Dennis   Auckley, MD Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University