MANILA, Philippines?Sleep is so important for human survival that we spend at least a quarter of our life?that?s over 20 years?snoozing. For people who snore, however, sleep is a potential health hazard.

Snoring can become a serious medical problem when it disturbs sleeping patterns and deprives the snorer of appropriate rest, according to Dr. Keith Aguilera, a sleep specialist and head of the Comprehensive Sleep Disorders Center at St. Luke?s Medical Center.

When snoring is severe, it can cause serious, long-term health problems such as Obstructive Sleep Apnea-Hypopnea Syndrome or OSAHS, Aguilera explains. Apnea means ?a pause in breathing?; hypopnea means ?slow or shallow breathing.? The syndrome is classified as mild, moderate or severe.

Pauses in breathing

?While sleeping, a person with OSAHS experiences pauses in breathing lasting at least 10 seconds and could occur as much as 100 times a night,? Aguilera says. The person usually stops snoring and resumes breathing after making a grunting or snorting sound.

Some persons with OSAHS wake up several times a night, sweaty and gasping for air. Although they sleep eight hours or even longer a night, people with OSAHS frequently complain of fatigue, sleepiness, sluggishness and poor concentration during the day. As a result, many are involved in traffic- or work-related accidents, poorer work performance and even poorer social relationships due to their shortened temper.

?Because their heart and lungs actually work harder when they are asleep than when they are awake, people with OSAHS are at high risk of suffering heart enlargement, high blood pressure, stroke and heart attack,? Aguilera warns.

Problem snoring

According to Aguilera, almost half of normal adults snore occasionally while 1 in 4 are habitual snorers. Problem snoring is more frequent in males and overweight persons, and usually worsens with age.

Snoring sounds occur when there is narrowing in the free flow of air through the passages at the back of the mouth and nose. The narrowing causes ?traffic? in the flow of air making it turbulent, cause all the surrounding soft structures to vibrate, thus creating the snore sound. The area where the tongue and upper throat meet the soft palate (the back, muscular part of the roof of the mouth) and uvula (the soft flap of tissue that hangs down at the back of the mouth) is also the most collapsable part of our airway. When the snoring worsens, these structures collapse and will lead to an obstruction of airflow, cutting off our air.

OSAHS occurs in 4 percent of males and 2 percent of females aged 30 to 60 years, according to Aguilera. Its incidence in women rises after menopause. It also occurs in children but produces different symptoms. Aside from snoring, other OSAHS symptoms in children include daytime sleepiness, bedwetting, decreased attention, unusual behavior and poor academic performance. Three to 12 percent of children snore, with 1 to 10 percent having OSAHS.

Diagnosing OSAHS and its severity through patient history and physical examination alone is right only half of the time, Aguilera notes. To confirm the diagnosis, an overnight polysomnographic (PSG) study is performed in a sleep laboratory under direct medical supervision. In a PSG study, the patient?s brain, heart, lung, blood oxygen, snoring, body position, muscle and airflow data are recorded by a computer during sleep. These data are then analyzed and interpreted by a sleep specialist.

Treatment of choice

The treatment of choice for OSAHS is still continuous positive airway pressure (CPAP) therapy, Aguilera says. In CPAP, the patient wears a device that pumps air through a mask to prevent the collapse of the airway during sleep. With continuous and proper administration, CPAP reverses symptoms of OSAHS like sleepiness and morning fatigue, and reduces the risk of complications such as hypertension and risk for stroke and heart attack.

?However, almost half of patients will discontinue CPAP therapy. For this reason, patient education is vital,? Aguilera explains.

Fortunately, surgery provides an alternative. Surgery can be done on the nose, palate, tonsils and larynx in single or multiple stages, Aguilera says. Because snoring and OSAHS involve a number of anatomical structures and their causes and severity vary widely between patients, only a sleep surgeon can decide whether surgery is the best option.

?If your loved ones say that you snore heavily, consider seeing a sleep specialist,? Aguilera says. ?You could be sleeping with the enemy.?

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Angelo Palmones is a science and technology broadcaster. For feedback, please e-mail the Healthcare Technology and Outcomes Information Bureau at inquire@htoib.com.