Could Balloon Sinuplasty Help You Sleep Better?

Chronic sinusitis can be a terribly painful condition. In my practice, I have seen many patients come to me suffering from headaches caused by pressure in their eyes, nose, cheeks and forehead. Patients with a sinus infection cough frequently, have a continuous runny nose, difficulty breathing because of their congestion, and snore which interrupts their sleep patterns.

For many people who suffer from chronic sinusitis, their symptoms can last from three months to years, as opposed to acute sinusitis which lasts for a few days to three months. Over an extended period of time, antibiotics may not work, and in those cases, patients have additional options. Today, there is a relatively new procedure to treat blocked sinus passages called Balloon Sinuplasty™ — a less-intrusive form of surgery that can be performed in a doctor’s office on an out-patient basis.

The FDA cleared this technology and it is clinically proven to be safe and effective. The procedure includes and endoscopic catheter that uses a small, flexible balloon that is inserted into the sinus passageways, and inflated. Then it gently restructures and widens the walls of the passageways, which restores the normal ability for the sinuses to drain, while maintaining the integrity of the sinus lining.

Balloon Sinuplasty™ Technology is an endoscopic, catheter-based system for patients suffering from sinusitis. It uses a small, flexible, sinus balloon catheter to open up blocked sinus passageways, restoring normal sinus drainage. When the sinus balloon is inflated, it gently while maintaining the integrity of the sinus lining.

To determine if you have either acute or chronic sinusitis, and if that is the cause of your snoring, you should visit a doctor of otolaryngology (ear, nose and throat doctor) who will run a series of simple to complex tests.

Sinusitis is often caused by allergies or a physical abnormality such as a deviated septum, or malformed bone. A nose and throat exam will most likely be a starting point that will reveal potential blockages. This exam will help your doctor identify the possible abnormalities that may cause snoring. If your doctor needs a detailed image of your sinuses, he may perform a CT scan (Computerized Tomography Scan). This test provides a detailed cross-sectional image of the sinuses and can be used to help identify the severity of infection inside the sinus cavities. To determine if the cause of your sinusitis is from allergens, your doctor may refer you to an allergist for a detailed evaluation.

If you suffer from facial pain and pressure, recurring sinus infections and sinus headaches, Balloon Sinuplasty™ technology may be the answer to your chronic sinusitis. Contact your doctor today and schedule an examination, or if you’re in the New York City area, feel free to contact the Manhattan Snoring and Sleep Center for expert diagnosis.

Dr. Volpi is the founder of the Manhattan Snoring and Sleep Center, and has had a private ear, nose and throat practice in New York City for more than 20 years. He and his medical staff at Otolaryngology Associates are board-certified surgeons and members of New York’s finest teaching hospitals.
 
This article is intended for general information only is in no way intended to be a substitute for receiving direct medical advice from a medical professional, their diagnosis or treatment. If you have any questions regarding a medical condition, or if you suspect you may have a snoring disorder, contact your physician. If you think you may have a medical emergency, call your doctor or 911 immediately. 

Brain Damage from Snoring?

Brain Damage from Snoring?

Snoring from sleep apnea can have dangerous consequences. For years physicians have known that chronic snoring can cause daytime symptoms of fatigue that affect cognitive function and memory loss due to the interruption in sleep it causes. A new study out of Australia from the Institute for Breathing and Sleep at Melbourne’s Austin Health reveals not just an impact in function. Snoring while you sleep could be the cause of brain damage.

During the Australian study, brain scans of 60 people in their mid 40’s who were recently diagnosed with sleep apnea, a common sleep disorder, showed “a decreased amount of gray matter” compared to healthy sleepers. Sleep apnea is caused by the airways collapsing while asleep at night, pausing breathing and forcing sleep apnea sufferers from rousing from a deep sleep, sometimes “hundreds of times a night,” according to Dr. O’Donoghue of Austin Health. This pause results in the brain being deprived of oxygen as well as "surges in blood pressure".

Since the scans showed decreased amount of grey matter in the brain, it meant there was damage in certain areas. According to O’Donoghue, the damage was evident in two pockets of the brain, one that handles memory and the other known to allow smooth movement and changes in attention during complex tasks. Earlier studies have showed that this part of the brain is activated during a driving task, and therefore may explain why sleep apnea patients have an increased risk of car accidents.

"What specific part of sleep apnea might cause these changes we can’t say, but we can see the changes that have occurred…The take home message is if you complain of these sort of symptoms it is not a good idea to ignore it, you should seek help," Dr. O’Donoghue said.

This research was presented at the 22nd Annual Scientific Meeting of the Australasian Sleep Association and Australasian Sleep Technologists Association Conference, in Christchurch, New Zealand.

Obstructive Sleep Apnea — A Risk Factor for Coronary Artery Disease

An on-going study taking place in Sweden has released preliminary findings that suggest that obstructive sleep apnea (OSA) may be an even stronger risk factor for coronary artery disease than diabetes, obesity, hypertension and even smoking.

At the European Respiratory Society 2010 Annual Congress last week, Swedish pulmonoligist Yuksel Peker from the Skaraborg Hospital in Sweden presented his latest finding from the ongoing Randomized Intervention with CPAP in Coronary Artery Disease and Sleep Apnea (RICCADSA) trial.

Although the study is on-going, he acknowledged, he also stated “analyses of baseline demographics and comorbidity profiles continue to strongly support OSA as a risk factor for CAD.” The study was started in 2005 to analyze the impact of continuous positive airway pressure (CPAP) on patients who had undergone revascularization for CAD and who also had OSA. ”Not only is the prevalence of OSA ‘surprisingly high,’” Dr. Peker said, but "these patients do not always show typical symptoms such as sleepiness.“

OSA was found in 64% of those with CAD. Comparitively, 58% had hypertension, and 28% were obese, making OSA much more common that was before thought of as more “conventional” risk factors. In addition, CAD patients with OSA were older than those without, were more obese, we mostly male, and had higher incidents of hypertension, diabetes, and atrial fibrillation.

Dr. Peker looked at both OSA syndrome (or "sleepy OSA," because of daytime sleepiness symptoms) and "nonsleepy OSA." He found that the CAD risk increase was present with both types of OSA.
The good news seems to be that those CAD patients that were studied with OSA had better compliance to the CPAP treatment. Dr. Peker indicated, “if we ask the CAD patients to use CPAP so far, they appear motivated enough to follow treatment.” At this point there is no proof that CPAP treatment actually reduces the risk for cardiovascular disease, however Dr. Peker suggested that it should be thought of as a “secondary cardiovascular prevention method.” The final results of the study are due out in 2012.

European Respiratory Society (ERS) 2010 Annual Congress: Abstract 5374. Presented September 22, 2010.

More Veterans are Suffering from Sleep Apnea

The Veterans Administration announced that from 2008 to 2010, the number of veterans who receive benefits for sleep apnea increased by 60%, and that more than 20% of military veterans suffer from the sleeping disorder, compared to the estimate of 5% for those not in the military.

Although one of the main causes can be excess weight, the VA doctors suspect that repeat deployments to Iraq and Afghanistan are exposing the military service members to dust and smoke which are contributing to the increase in cases.

More than 63,000 veterans receive benefits for sleep apnea, which can cause daytime drowsiness, heart disease, and even strokes. The most common treatment is the continuous positive airway pressure (CPAP) mask. Although the Social Security Administration recognizes sleep apnea as a disability and pays benefits to those who can’t work, the VA says veterans can receive benefits and hold jobs.

The Department of Veterans Affairs is expected to spend approximately $500 million a year to treat veterans with sleep apnea, and it is expected to rise in the upcoming years. Considering that sleep apnea is linked to serious conditions such as heart disease, diabetes, hypertension, obesity, and daytime sleepiness which can cause memory loss and decrease work productivity, it is critical that these veterans receive appropriate care.

Sleep Apnea the Cause of Percy Harvin’s Lifetime of Mystery Migraines

While in the hospital after collapsing on the field last month, Percy Harvin’s doctors made a startling discovery. Harvin had been suffering from migraines since he was a child, and his doctors had tried almost everything to treat them. The NFL offensive rookie of the year and Vikings receiver had headaches that kept him from practice and games several times last season, and he blamed his collapse on the migraine medication he had been taking.

During his overnight stay in the hospital, the doctors discovered he had stopped breathing during while he was asleep several times, and tests proved his heart had stopped twice. They immediately suspected sleep apnea and ordered him onto a breathing device, most commonly used is the CPAP, (Continuous Positive Airway Passage) which treats sleep apnea by providing a steady flow of air through a mask that it placed over the nose.

Since then, Harvin has been sleeping with the device, and the  results have been remarkable. According to Harvin, his migraines are gone and he no longer needs the migraine medication. Doctors believe that the lack of sleep he was suffering due to the sleep apnea had triggered his migraines. According to Harvin, he is getting more uninterrupted sleep and “feeling great,’” he told Pioneer Press at Twincities.com.  "It's a 100-percent difference, I'm not waking up groggy. I'm refreshed and ready to go. Hopefully, that's it," he said.

Harvin is lucky indeed that his sleep apnea was diagnosed and he is now receiving treatment. During a sleep apnea event, the airway becomes obstructed during sleep, blocking air flow and resulting in an emergency arousal that causes the person to gasp for air. Besides migraines as a symptom, sleep apnea and its related sleep deprivation can cause a variety of daytime issues including irritability, burnout, depression, and poor job performance, lack of concentration and memory loss. What’s more, because sleep apnea affects the heart it can lead to arrhythmia or abnormal heart rhythm, or enlargement of the heart. Since it can drop one’s blood oxygen level abnormally low, it can lead to high blood pressure, stroke and lung dysfunction if it is left undiagnosed.

If you’re suffering from daytime symptoms such as the migraines that Harvin experienced, or if you suspect you may have sleep apnea, it is important to seek diagnosis and treatment from a board-certified Otolaryngologist (ear, nose and throat specialist). It’s important to proactively seek treatment, because the chance of accidentally discovering sleep apnea is rare, and lucky indeed. If you’re in the New York tri-state area, schedule an appointment online at the Manhattan Snoring and Sleep Center.

Dissecting the Pillar Procedure

The Pillar Procedure, a minimally
invasive, simple and safe
treatment for snoring.

Since its approval by the FDA a few years ago, the Pillar Procedure has been gaining in popularity as a remedy for snorers throughout the world. With widespread adoption by the medical community, many snoring sufferers are finally finding relief by turning to this procedure. Here are the facts.

Snoring is a complicated disorder, and there are many reasons why a person might snore. Causes such as a deviated septum, sinus disease and large tonsils are just a few reasons, and they are all physical conditions that need to be treated using specific methods. Another common cause of snoring is the fluttering of the soft palate while asleep, which can also occur with less severe forms of obstructive sleep apnea (OSA). If that is the cause of a snorer’s condition, then there is a good chance it can be treated by the Pillar Procedure.

Worldwide, so far more than 30,000 people have been treated with the Pillar Procedure. It is a minimally invasive, simple and safe treatment for snoring and mild to moderate OSA which can be performed in a visit to the doctor’s office.

The Pillar Procedure involves stiffening the soft palate and offering structural support, reducing the vibration of the tissue that is causing the snoring when the palatal tissue collapses and obstructs the upper airway. During the procedure, three small polyester implants are placed into the soft palate and over time, the implants, together with the body’s natural fibrotic response, provide support to the soft palate.

After the procedure, patients’ snoring is reduced or cured, providing relief to their daytime sleep deprivation symptoms. The Manhattan Snoring and Sleep Center is a leading provider of the Pillar Procedure in New York City, and has successfully cured hundreds of patients from suffering from their snoring disorders.

Why Home Sleep Testing is Revolutionizing Sleep Apnea Treatment

Although home sleep apnea testing equipment has be utilized for a few years, it wasn’t until recent findings presented at the American Thoracic Society 2010 International Conference confirmed that patients that used the home sleep test showed similar improvements in their obstructive sleep apnea (OSA) treatment as did patients who had their sleep testing performed in an overnight lab.

Prior to the findings of this study, it was commonly thought that patients would have the most successful treatment if they stayed overnight in a lab, because they would be spending more time with a technician who provides education of OSA and the importance of its treatment, which would improve the patient’s compliance using the standard CPAP (continuous positive airway pressure) device of their treatment once at home. Since many patients complain about the discomfort of the CPAP, compliance is difficult for many.

However, as this study found, of 300 patients who randomly either underwent their sleep testing in the lab or at home, 185 of them completed three months of follow-up treatment. The results of their OSA improvements using CPAP treatment where similar regardless of whether they had their sleep testing done in the lab or in the home.

The Manhattan Snoring and Sleep Center now offers home sleep testing equipment to qualified patients, and has found similar results as this study with its own patients who either under go sleep testing at the center’s overnight lab or at home.

A home sleep test is used only to diagnose sleep apnea, and obstructive sleep apnea is the most common type, as well as the most serious. It is caused by an obstructed upper airway in which soft tissue of the palate, throat or tongue blocks the flow of air as a person struggles to breathe. Since OSA symptoms can lead to severe health conditions, it is very serious and important that patients receive expert medical care and guidance. There are other physical causes of snoring and apnea, and since home sleep tests only diagnose apnea, a patient should have a thorough physical exam first to see if the test is right for them or if a different line of treatment is necessary. Even if sleep apnea is suspected, there are other factors that may make a test in an overnight sleep lab necessary.

Visit the Manhattan Snoring and Sleep Center website for more information about the home sleep test. If you suspect that you have sleep apnea or if snoring is keeping you from getting a good night’s sleep, contact us today to schedule an appointment.

For Obstructive Sleep Apnea Sufferers, Throat Exercises Provide Relief

There is a simple (and free) technique that researchers from Brazil have studied, suggesting that exercising the throat muscles may improve severe obstructive sleep apnea symptoms. These throat exercises, derived from speech therapy, seem to work because they have a marked ability to strengthen and tone the muscles of the throat, even reducing the circumference of a patient’s neck.

Sleep apnea is a potentially life threatening sleep disorder that is caused when the muscles of the throat collapse during sleep. Obstructive sleep apnea (OSA) is the most common type of apnea and also the most serious because it causes the soft tissue in the palate, throat, or tongue to “obstruct” the flow of air as a person struggles to breathe while they are asleep. Apnea is particularly severe when there are more than twenty or thirty events per hour because it severely limits the amount of oxygen the person receives throughout the night. Carrying extra weight, especially around the throat area has been found to be a related cause of OSA.

According to an article last month in The New York Times, a study on the effects of specific throat exercises on obstructive sleep apnea patients was conducted by the Heart Institute’s Pulmonary Sleep Laboratory at the University of São Paulo Medical School in Brazil. Researchers split the OSA patients into two groups. One group was instructed to do simple breathing exercises every day, the other group was instructed to do 30 minutes of throat exercises a day, comparable to those that speech therapists employ. The motions included swallowing and chewing, sliding the tongue back and forth to front of the palate, and repeating particular vowel sounds quickly. This exercise technique may be an alternative for some patients to the most widely known treatment of sleep apnea today, the CPAP (Continuous Positive Airway Pressure) machine, which is attached to a mask the patient wears while asleep.

The researchers found that after three months, the group that only did the breathing exercises had almost no improvement, while those that performed the throat exercises reduced the severity of their sleep apnea by 39 percent. Although the patients’ body mass index remained consistent, also noted was that the exercises reduced the circumference of the subjects’ necks significantly. The study also stated they snored less and slept better, concluding that throat exercises “significantly reduce Obstructive Sleep Apnea severity and symptoms, and represent a promising treatment for moderate OSA.”

The report analysis can be found at PubMed.org. For more information about the available treatments of obstructive sleep apnea, including a throat exercise program, contact The Manhattan Snoring and Sleep Center. If you suspect you have sleep apnea, it is important to get the treatment you need.

Snoring: It’s in the Air that You Breathe

Using EPA air pollution data from a number of different American cities, researchers have established the first link between air pollution and both hypopnea (under breathing) and apnea (pauses in breathing) during sleep. Also studied was the affect that increases of temperature play on these sleeping disorders. Known as sleep disordered breathing (SDB), hypopnea and apnea can cause temporary elevations in blood pressure, lower blood oxygen levels, and can lead to high blood pressure and cardiovascular diseases.

In a study that will be published in the upcoming issue of the American Journal of Respiratory and Critical Care Medicine, researchers from Brigham and Women’s Hospital and the Harvard School of Public Health have explored the effects of air pollution and temperature increases on sleep apnea and hypopnea episodes. Using data from the EPA monitoring air pollution levels in 7 U.S. cities (Framingham, Minneapolis, New York City, Phoenix, Pittsburgh, Sacramento and Tucson), they studied it against data from the Sleep Heart Health Study of 6,000 people from 1995 to 1998.

The doctors were looking to find a correlation between “the elevation in ambient air pollution with an increased risk of SDB, nocturnal hypoxia and with reduced sleep quality,” as well as how “seasonal variations in temperature would exert an independent effect on SDB and sleep efficiency.” Using the data, and taking into account certain seasonal variables, they looked at known SDB factors including a patient’s age, gender and whether or not they smoke.

The results were that this is the first study to link air pollution and sleep disordered breathing. Antonella Zanobetti, Ph.D, a researcher on the project stated, ’We found novel evidence for pollution and temperature effects on sleep-disordered breathing.” They also found that increases in sleep apnea or hypopnea “were associated with increases in short-term temperature over all seasons, and with increases in particle pollution levels in the summer months." The short-term rises in temperature were associated with changes in respiratory disturbances, blood oxygen levels and decreases in sleep efficiency.

Sleep disordered breathing affects nearly 17 percent of the adults in the U.S., and many more aren’t aware they have a problem, since the episodes happen at night. If you feel you might suffer from a sleep apnea or hypopnea, because you’re experiencing some of the daytime symptoms, it is important to get treatment.

To get more information on how to treat sleep apnea or snoring disorder, contact The Manhattan Snoring and Sleep Apnea Center.

Drivers with Sleep Apnea – A Deadly Blend

Drivers with sleep apnea continue to be a hazard, and pose a worrisome combination. Hundreds of International researchers and doctors convened at the 3rd Annual Swedish Sleep Medicine Congress this past April in Gothenburg, where an important research study which examined public transportation drivers in Sweden who had undiagnosed sleep apnea. Results could potentially impact professional drivers everywhere for years to come.

Mahssa Karimi of the Center for Sleep and Vigilance Disorders presented her findings of a study conducted which examined sleep disorders of 116 bus and tram drivers in Gothenburg. The researchers had to first diagnose the drivers, many of whom had not previously sought medical attention for sleep disorders and sleep apnea. It was discovered that 19% had sleep apnea.

Since past studies have linked drivers with sleep apnea to a higher rate of car and truck crashes, these findings point to the importance of getting sleep apnea patients, especially those who are on the roads for a living, the treatment they need to keep the public safe. As Karimi said, “Our findings suggest that it's important to systematically examine professional drivers and other professional groups entrusted with the safety of others in order to be able to treat any sleep disorders, as their work demands alertness and concentration at all times."

Two years ago, a study published in the medical journal Thorax and conducted by Vancouver Coastal Health Research Institute and University of British Columbia revealed that sleep apnea patients are at double the risk of being in a car crash, and are three to five times more likely to be in a serious car crash involving personal injury. In the largest study of its kind, researchers used data from the Insurance Corporation of British Columbia to study 1,600 patients with and without sleep apnea.

In another study conducted by the medical director of Lifespan's Employee Health and Occupational Services, Dr. Philip Parks, and The Cambridge Health Alliance, further showed the link of obesity in truck drivers and sleep apnea. Researchers examined 456 truck drivers from more than 50 employers. Of those, 17% had Obstructive Sleep Apnea, most who were older, obese and had higher than average blood pressure. "It is well-known that obesity, a leading risk factor for obstructive sleep apnea, is on the rise in the United States. Truck drivers with sleep apnea have up to a 7-fold increased risk of being involved in a motor vehicle crash," said Dr. Parks. Due to that study, the Federal Motor Carrier Safety Administration is deliberating recommendations to require sleep apnea screening for all obese drivers based on body mass index.

Unfortunately, many of the patients in these studies didn’t even report that they had daytime sleepiness, suggesting that many don’t realize they have sleep apnea and aren’t aware of the potential hazard they cause while driving. Considering that sleep apnea causes excessive daytime sleepiness, impairs motor skills and diminishes thought function, we at Manhattan Snoring and Sleep Center strongly recommend that if you suspect that you have any symptoms of sleep apnea, you seek diagnosis and treatment right away, especially if you drive professionally. The risks to yourself and others when you’re on the road make sleep apnea and driving a dangerous combination. Contact us today.

Roll Over and Stop Snoring! Truth or Wives’ Tale?

Many people think it’s an old wives’ tale—that rolling over from your back to your side when you’re sleeping will stop your snoring. Maybe it’s because wives are usually the ones poking their snoring husbands to roll over in the middle of the night! But just like many myths, there is a hint of truth to the tale.

To start, we must first understand why we snore. During sleep, our throats relax causing the tongue to fall into the airway in the back of the throat. Snoring is caused when there is an interruption to the free flow of air through the nose and throat causing a vibration that produces the sound of snoring. There are many reasons why air may block breathing so people can snore for many different reasons. There are many factors that can trigger the interruption of airflow including a person’s weight, whether they smoke, take certain medication, or have allergies. Physical causes can include if someone’s had a nose or throat injury or if they were born with narrow passages, and more.

For some people, gravity produces an increased amount of obstruction from the tongue occurs when they sleep on their backs, which is described as “positional snoring.” This type of snoring explains why snorers often complain about being "frequently assaulted" throughout the night by their spouses, and implored to roll over.

If you’re a snorer whose favorite sleeping position is on your back, a simple solution to keep you off of it is to sew a ball into the pocket of a t-shirt that is then worn backward during sleep, keeping you off of it and sleeping on your side or stomach. If you feel muscle strain in your lower back when you sleep on your side, many people feel more comfortable when they sleep with a pillow between their knees. Some positional snorers also improve when the head of the bed is elevated or they sleep on an extra pillow.

So there definitely is truth to the wives’ tale, but unfortunately, not for everyone. If you have tried keeping off your back when you snore and it’s not working, there may be other physical factors that are causing it, and it makes sense to have a snoring specialist examine you to discover the reason. Snoring can be more than an annoyance, and can negatively affect your health as well as daytime productivity.

If you’re in the New York City area, contact us today at the Manhattan Snoring and Sleep Center to set up your appointment and start your treatment.

Spring Allergies: Itchy Eyes, Sneezing… Snoring?

With the stretch of warm weather we’ve had this spring in the North East, nature is blooming in abundance. And I’m seeing an abundance of people seeking help for their snoring. Coincidence? Not likely. Every year at this time, it’s common for the simple reason that many people suffer from seasonal allergies. Allergic reactions can lead to symptoms that include suffering from snoring.

Allergies, as well as asthma, cold and sinus infections (sinusitis) can cause blocked airways. So, people who regularly sleep with their mouths closed with no symptoms of snoring, have to open their mouths to breathe while they sleep if they have reactions to allergies. The blocked airways make inhaling difficult and cause people to sleep with their mouths open, creating a vacuum in the throat that leads to snoring.

Allergic reactions can mimic sinusitis (sinus infection), which is an inflammation of the sinuses and nasal passages that is characterized by a headache or pressure in the eyes, nose, cheek area, or one side of the head. Patients with a sinusitis may also have a cough, a fever, bad breath, and nasal congestion with nasal secretions.

Nasal allergies, which are either seasonal or constantly recurring, increase nasal congestion and can lead to sinusitis. Numerous treatments are available to provide identification and avoidance of allergens. For example, this time of year dust allergies are common, whereas in the fall, mold allergies are more prevalent. Exposure can be reduced with the use of non allergenic bedding, removal of carpeting or upholstery, and the use of an air cleaner with a High Efficiency Particulate Air (HEPA) filter.

Additional treatment for nasal allergies include:

• Prescription Nasal Steroid Sprays which decrease allergic and non allergic inflammation in the nose and can be safely used for a long period of time.
  
  
• Non Sedating Antihistamines reduce allergic nasal congestion when used alone or with nasal spray.
  
  
• Allergy Injections are for patients with long-standing identifiable allergies (that may be identified through skin or blood tests). Allergy injections gradually reduce symptoms and the need for medication.

This time of year, with the many trees and flowers blooming, symptoms that lead to snoring are common, even in those who throughout the rest of the year don’t snore. If you’ve recently been snoring, and wish to know the reason why as well as get the appropriate treatment, contact the Manhattan Snoring and Sleep Center today.

Snoring a Problem? Try Losing Weight…

One of the most common factors that contribute to a person who snores is their weight. Typically, people who are obese have the most problems with respiratory symptoms during sleep. Even what seemingly may seem a small weight issue of 10-15 extra pounds may cause snoring. Although there are other factors that may contribute to snoring, if you’re overweight, weight reduction should be one of your chief goals.

To understand why, you must understand what physically causes snoring. During sleep, the throat relaxes and the tongue falls into the airway in the back of the throat causing a vibration in the soft tissue. Fatty tissue, chin folds and a very large neck, common in those that are overweight, are physical characteristics that can contribute to the snoring sound. Being overweight is linked to difficulties with snoring, regardless of any age. Weight reduction should be one of the chief goals of any overweight person who snores, because typically even the loss of a few pounds can reduce snoring.

However, there is no one solution to weight loss and management. There are vast differences in the human metabolism just as there are differences in anatomy. Weight loss programs are most successful when they combine a lower caloric intake with an exercise program. Since snoring can cause daytime fatigue, it’s often difficult at first for a snorer to get the energy up to start an exercise routine. With consistent effort, however, exercising can actually increase a person’s energy level throughout the day.

It is very important when beginning an exercise program, to start carefully and slowly at first because it is common for people to overdo it at first and become discouraged, or worse injured. It’s also important to get a green light from your physician first — he or she can start you on a program that is right for you.

You may find that you need to experiment with different approaches to dieting to discover what works best for you, since everyone’s metabolism is unique. Whichever approach you choose, commit to the long term for weight normalization, not just loss. The reason that most diets fail is that many dieters try to “force” weight off the body in an unhealthy or unnatural way. In other words, they focus on dropping pounds or losing weight rapidly, as opposed to normalizing their weight in a more natural way over a longer period of time. Sustaining a normal, healthy weight takes patience and a commitment to eating healthy and exercising regularly.

Weight loss reduces snoring in many people, sometimes stopping it completely. It also improves sleep and significantly reduces daytime sleepiness, allowing for a more productive waking day as well. To find out if your weight is a factor in your snoring, schedule an appointment today with the Manhattan Snoring and Sleep Center for an evaluation.

The Stress of Snoring on a Marriage

Can snoring ruin a marriage? In my practice, I hear the complaints all the time. Since it is more common in men than women, wives often make the appointments for their husbands, or the husband will say “my wife made me come in.” Snoring can cause a couple who are normally affectionate and enjoy a healthy home life to become resentful of each other. The non-snoring spouse blames the snorer for causing them to be up all night, the snorer blames the non-snoring spouse for not being understanding.

The reason for resentment is understandable. Snoring can cause daytime symptoms that can wreak havoc on one’s waking life, and unfortunately, it is not just the snorer that suffers – the spouse can suffer just as much. The sleep loss associated with snoring impairs a person’s ability to perform tasks involving memory, learning, reasoning, and mathematical processes. It can cause morning headaches, irritability, burnout and depression to mention just a few symptoms.

It is thought that more than forty million Americans snore every night and that 60% of men snore, and 30% of women. With all that snoring at night, couples are having a hard time sleeping together. According to the National Sleep Foundation, 53 percent of adults say they have relationship problems because of their or their partner's sleep disorder. The housing industry even seems ready to capitalize on this trend, with one survey predicting that by the year 2015, more than 60 percent of custom homes will have dual master bedrooms to be occupied primarily by snoring spouses.

In his book, "Two in a Bed: The Social System of Couple Bed Sharing," Paul C. Rosenblatt explores couples sharing their sleeping space, and it is a groundbreaking book in the field of sleep and relationships. For the book, Rosenblatt interviewed 42 couples, and examines how sharing a bed affects the couple’s relationship.

Many couples described that sleeping in the same bed is extremely important to them, because “it's a time for intimacy, pleasure and feeling comfortable together. During the time before drifting off to sleep, couples catch up on what's going on with one another, plan, make decisions, deal with disagreements and solve problems. For most couples, their time chatting in bed is the most time they have to talk with each other on a daily basis and that talk can be crucially important to their relationship,” Rosenblatt said."If couples don't have this time in bed, then they're in trouble.”

Although many couples know that it’s healthier for their marriage to share that time, sense of security and intimacy, many with snoring spouses are opting to go it alone in separate rooms for the sake of a good night’s sleep and a productive, healthy day.

If your marriage is suffering because you or your spouse snores, the answer to your problem maybe easier to solve than you think. The key is to understand that snoring is a symptom of a physical condition, such as sleep apnea, sinusitis, or nasal obstruction and it can be treated. There are many non-surgical and surgical treatments available to snorers today, dependant on the cause of the disorder. Sometimes snoring can be treated with changes in lifestyle, but when that doesn’t work, medical evaluation is necessary.

Help get your marriage get back on track, and start getting a good night’s sleep. Contact us at the Manhattan Snoring and Sleep Center to schedule your online appointment or call 212-873-6036 today.

-David O. Volpi, M.D., P.C., F.A.C.S.,

The Stroke Connection: Heavy Snoring and Narrow Arteries

By David Volpi, M.D., P.C., F.A.C.S., The Manhattan Snoring and Sleep Center

In a study completed last year in Australia, researchers calculated that heavy snorers have an elevated risk for carotid artery stenosis, a narrowing of the arteries that supply the brain with blood. When those arteries are blocked, it can lead to stroke.

It’s been long known that high cholesterol, hypertension, smoking and obesity are linked to carotid artery narrowing. This new risk as discovered after 110 volunteers – a mixture of men and women ages 45-80—were measured for the extent of plaque in the arteries and spent the night in a sleep lab monitoring the timing of their snoring. The study showed that those that were the heaviest snorers (after adjusting for sex, body mass index, hypertension and other factors) had the 10 times the risk of those who snored the least.

Associate Professor of Medicine at the University of Sydney, John R. Wheatley was the lead researcher, and believes that the vibrations of snoring may cause damage to the epithelium, the cells that line the inside of the artery, leading to inflammation and plaque buildup. He acknowledges that the results of this study do not establish a “causal relationship” between artery blockage and snoring. For that a much larger sample must be studied. However it is clear that the study reveals heavy snoring may increase the risk for stroke.

Are you a heavy snorer? Snoring may be caused by a number of factors, and can be treated. Often lifestyle changes such as losing weight, exercise, quitting smoking and stopping alcohol consumption prior to bed are enough to cause snoring to stop. However, sometimes snoring is caused by physical issues such as nasal obstruction or chronic sinus infections. Whatever the cause, there are non-surgical and surgical means that can treat snoring.

If you are a heavy snorer, we recommend you have an examination by an otolaryngologist (ear, nose and throat) physician to assess what is causing your snoring and how it should be treated. For more information on the causes of snoring, visit www.nycsnoringsleepapneacenter.com.

If you’re within the New York tri-state area, contact the Manhattan Snoring and Sleep Center today to schedule an appointment.

Losing Weight Can Reduce – Even Rid Sleep Apnea

By David Volpi, M.D., P.C., F.A.C.S., The Manhattan Snoring and Sleep Center

New research shows that obese sleep apnea patients who lose just 10 percent of their weight can significantly improve their symptoms and potentially rid themselves of the sleep apnea all together.

According to an article in Health News last September, the Center for Obesity Research and Education at Temple University in Philadelphia, and researchers at four other medical centers and universities analyzed data on 264 obese patients with type 2 diabetes and sleep apnea in varying forms. Those in weight loss treatment lost an average 10 percent of their beginning weight, and realized a significant reduction in number of sleep apnea episodes they suffered. Many moved to less severe categories, from moderate to mild, and 14 percent had complete remission of the disorder. Men with severe apnea who lost the most weight saw the greatest benefit.

It is thought that sleep apnea affects more than 18 million Americans. It is a potentially life-threatening disorder that can lead to heart disease, increase blood pressure, cause lung dysfunction and lead to stroke. A sleep apnea patient stops breathing during sleep for usually ten to twenty seconds, sometimes a minute or more, many times throughout the night. Obstructive sleep apnea is the most common type, and also the most dangerous. It is widespread in overweight and obese people because excess weight can cause the soft palate in the back of the mouth to collapse and block airway. However it should be noted that there are anatomical abnormalities such as a narrow throat or large tonsils that can also cause sleep apnea.

Unfortunately, it often goes undiagnosed because sleep apnea episodes occur only during sleep. Recognizing daytime symptoms, which include fatigue and daytime sleepiness (especially when it is thought that the patient should have received enough rest) is key to discovering this potentially life threatening disorder. If you believe you may have sleep apnea, it is important to have a physical examination by an otolaryngologist (ear, nose and throat doctor) to get started on treatment. If your weight is a factor in your sleep apnea, your doctor can lead you to a weight loss program that is right for you.

It’s long been known that overweight and obese people are at risk for numerous health problems. It’s also known that in addition to lowering or ridding sleep apnea, by losing just 10 percent of body weight, overweight patients can improve their heart function, lower blood pressure and levels of blood cholesterol and triglycerides, and decrease the risk of diabetes and cardiovascular disease – all reasons why weight management should be an important goal for a healthy lifestyle.

Those who participated in the weight loss study lost an average of 24 pounds by taking part in group behavior modification, eating a portion-controlled diet with liquid meal replacements, and exercising for 175 minutes per week for one year. “This is one of the first and certainly the largest study ever conducted,” Foster said. “It’s been clear that obesity increases the risk of sleep apnea but less clear that if obese people or people with type 2 diabetes lost weight, it would result in significant improvements in their sleep apnea—and it did.”

The study findings were published in the September 28 issue of the Archives of Internal Medicine. Read more about sleep apnea visit the Manhattan Snoring and Sleep Center.