ANN ARBOR, Mich. - Heavy snoring can be far from a nuisance. It can be a sign of obstructive sleep apnea, a condition where an individual briefly stops breathing during the night which raises the risk of heart failure and strokes.
"Sleep apnea or sleep disordered breathing is one that we're getting more and more interested in because we see a very strong association with strokes, heart attacks and other cardiovascular problems," says Melvyn Rubenfire, M.D., director of Preventative Cardiology at the University of Michigan Health System's Cardiovascular Center.
The cardiovascular risk factors that most often come to mind are smoking, diabetes, high blood pressure, high cholesterol and family history. But it's important to be aware of the possible health risks of heavy snoring.
Snoring is caused by a blockage in the back of the throat. What you hear is the tongue forced to the back of the throat when a person is lying on their back.
When people snore they don't always stop breathing, but there are chemicals in the brain that should trigger breathing that are not stimulated when a person snores. Without the stimulation the person will often stop breathing.
When a person obstructs at night and stops breathing, oxygen levels drop dramatically and hormones and adrenaline surge. Those hormones contribute to high blood pressure, irregularities of the heart and can trigger heart attacks
People who snore do not necessarily have obstructive sleep apnea but the relationship is pretty strong.
And the relationship between snoring and cardiovascular problems goes both ways. Those with heart problems are more likely to have sleeping disorders. For example, heart failure can lead to water retention - water buildup in legs, lungs and tissues in the back of the throat.
"So heart failure can be one of the causes of obstructive sleep apnea and obstructive sleep apnea can seriously worsen heart function and aggravate heart failure," Rubenfire said.
Studies had long suggested a connection between snoring and cardiovascular problems but men made up most of the study group. According to a large study published in the February 2000 issue of the Journal of the American College of Cardiology, women who snore regularly have about twice the risk of heart attacks and strokes than women who never snore.
"Still it may be too early to tell if snoring is an independent risk factor for heart disease," says Rubenfire who continues to review research on sleep disordered breathing as it relates to cardiovascular disease. "What we do know is if you treat people with obstructive sleep apnea the risk of cardiovascular disease improves dramatically."
Rubenfire explains that anyone who snores loudly, wakes without feeling rested or has hypertension, diabetes or is overweight is more prone to sleep disordered breathing or obstructive sleep apnea.
The most important step in treating snoring is recognition and appropriate diagnosis. A very effective treatment - one that helps 90 percent of those who are compliant with the method - is using a Continuous Positive Airway Pressure device.
"These are excellent devices, called CPAP, … these are masks that prevent you from obstructing by creating some pressure," says Rubenfire. "Simple snoring that's not very loud and without any other symptoms can usually be handled simply by turning on your side."