Another article about sleep apnea in the NY Times…

http://www.nytimes.com/2005/10/20/fashi ... snore.html

When the Z's You Get Aren't Yours

Published: October 20, 2005

By LIZETTE ALVAREZ

AS marriage proposals go, this one was textbook: A Caribbean cruise, a night bursting with stars, a pitch-perfect dinner and then, after retiring to a private balcony, a bottle of Dom Pérignon. Ed Silcox Jr. dropped to one knee and presented an impeccable diamond ring to the bride-to-be, Johanna Murtha, who stifled tears
They scurried to bed, blissfully falling asleep in each other's arms. Then the farce began: Mr. Silcox, 46, started to snore: a cabin-rattling crescendo that built from minor rasp to mind-blowing snort. The snores blew past his new fiancée's foam earplugs, defied a stack of over-the-head pillows and rumbled down hallways.
In no time Mr. Silcox was exiled to the balcony, where he slept night after night, braving the wind, the rising sun and a stream of dirty water from on high (as the deck hands cleaned the ship). A hotel in Puerto Rico offered little respite. In her desperation, Ms. Murtha, 40, chose to nap by the pool, in a howling thunderstorm, rather than snooze in bed next to her fiancé.
"We spent every night apart and fought virtually every night of the week," said Ms. Murtha, now happily Ms. Murtha-Silcox, who lives outside Philadelphia. "By the end of the cruise I was thinking, 'What did I say yes for?' We were exhausted. Our eyes were falling out of our heads."
For millions of women, snuggling up to a partner for a good night's sleep is as improbable as stumbling across a Chanel suit on a Kmart rack. Snoring is rampant, with some statistics showing that as much as 20 percent of the population snores. And there is no question that men snore a lot more than women; some experts say they are eight times more likely to than women.
In large part that has to do with men's thicker neck muscles, since snoring is what happens when air passes relaxed tissue in the throat, causing a full-throttle vibration. Indulging in too many cocktails makes snoring worse for the simple reason that it over-relaxes the body. Growing older, and less toned, exacerbates the problem. Sometimes genes are to blame; some people are just born with a flabby or narrow airway.
Weight gain, too, worsens snoring because the neck grows thicker. As America has gotten fatter, it also appears to have gotten louder, at least during sleep hours. Nowadays, though, many exhausted partners are refusing to sacrifice a good night's sleep.
The result, doctors say, is a modern version of musical beds, featuring legions of annoyed women stomping into the guest room or bleary-eyed men shuffling away after being banished to the couch. A number of sleep-famished, stressed-out partners skip this prelude altogether, preferring to sleep in a separate room to get a night of undisturbed rest.
In many snoring marriages, this arrangement is an open secret: not exactly hidden, but not readily divulged. "It's amazing how many people move to another room," said Dr. Michael J. Thorpy, director of the Sleep-Wake Disorders Center at Montefiore Medical Center in the Bronx. "People do it for months, if not years. People don't talk about it to others. There is some embarrassment. It's a feeling of failure that we can't handle this, and it comes really from the fact that snoring was not looked at as a medical problem, but something to be laughed about. We are starting to move away from that."
Dr. Mansoor Madani, director of the Center for Corrective Surgery in Bala Cynwyd, Pa., said he gave a series of questionnaires to 5,600 patients who came to him with snoring problems. Of those, he said, 85 percent said the snoring was so loud that the partners were forced to sleep apart.
In a survey of 1,506 randomly chosen people released this year by the National Sleep Foundation, 35 percent of those living with a snoring or fitful partner said they experienced difficulties in the relationship because of the disruption, 26 percent lost an average of 49 minutes of sleep a night and 23 percent acknowledged sleeping in a separate place.
Doctors are quick to point out that snoring can cause more than disharmony in a relationship. More than 12 million Americans suffer from sleep apnea - in which the soft tissue at the back of the throat repeatedly collapses during sleep and blocks off air - and a large number of these people find themselves sleepy at work or behind the wheel, irritable and unable to concentrate. In the most serious cases, apnea can lead to high blood pressure, and less commonly to stroke or heart attack as the body struggles for oxygen.
Newly married couples (who experience what Dr. Madani calls the "honeymoon shocker") and partners who have young children are the quickest to lose patience. Older women typically tolerated their husbands' snores, perhaps through gritted teeth, mostly for cultural reasons, but also because treating snoring was not an option 20 or 30 years ago.
Not so for today's younger women, who are more likely to banish their partners from the bedroom or urge them to lose weight, curtail drinking, use over-the-counter remedies (which don't always work) or visit a sleep specialist.
With America working harder than ever and sleeping less, sleep centers are sprouting in just about every city and major hospital, becoming a cottage industry. According to the American Academy of Sleep Medicine, the number of accredited centers is 883, up from 297 in 1995.
Add in the unaccredited centers (accreditation is not legally required), and the number may be around 6,000, some experts say. Waiting lists are common, in part because so many people are seeking treatment for snoring.
Patients at sleep centers are asked to stay overnight, so their snoring can be monitored and the cause pinpointed. One company, SleepQuest, now sells a sleep monitoring kit that people can use at home. Depending on the diagnosis, doctors (typically ear, nose and throat specialists) recommend weight loss or some form of mechanical treatment. Patients may be given air pressure machines, which continuously pump air through a mask while the patient sleeps. Or the patient's adenoids, tonsils or uvula (that bell at the back of the throat) can be removed to minimize vibration.
Mr. Silcox chose surgery, enduring the removal of his uvula and the shaving of his soft palate, an operation with an excruciating two-week recovery period. But that was only after it became clear that his wife-to-be had no tolerance for snoring.
"Any amount of snoring is bad," Ms. Murtha-Silcox said. She tried many tricks (there are 300 items patented to cure snoring): ear plugs for her, pills and Breathe Rite strips for him. If she nudged him onto his side, a move that often cuts off snoring, he would just roll back a few minutes later. Since Mr. Silcox didn't need to lose weight and didn't drink much, those solutions were dead ends.
Exasperated and bone weary, Ms. Murtha-Silcox ordered him onto the couch. (His snore cut through walls, so the next room was not an option.) He obliged. While Ms. Murtha-Silcox was perfectly happy sleeping apart, her mate was not. "I am a huggy person," he said, adding, "This relationship was going to go nowhere."
So in January Mr. Silcox went to see Dr. Madani. "I got de-snored," he said.
Justifiably impressed by his commitment to her, Ms. Murtha-Silcox married him in June.
Not all snorers are so willing to be treated. After 18 years of marriage and countless sleepless nights, Maureen Winger, of Orlando, Fla., issued her own ultimatum. Randy Winger, 44, who is "still in complete denial over his snoring," now sleeps on the couch every night, with his pillow and "blankie," as she calls it.
Denial is common, doctors say, and some partners go so far as to record their husbands to proffer evidence. Many men acknowledge the problem only after other men - vacation buddies - complain about their snoring.
"He sounds like a freight train," Mrs. Winger, 41, said. "I elbow him and kick him, and I don't want to be abusive. I'm not a violent person, but I became a violent person. I don't want to have spouse abuse in my house."
Mrs. Winger confides that he has accused her of snoring too. "Frankly, I think I do, but I never wake him up," she said.
Snorers and their mates dread vacations, especially if it means going to a hotel, for the simple reason that there is no easy escape. "I've seen people who have reported sleeping in bathtubs," Dr. Thorpy said. "You would be surprised how many times that happens."
Melanie McCafferty, 44, said she would always scope out the sofa when visiting friends and warn them she would probably get snored out of her room by Alex Fantoni, her husband. If her friends reacted with bemusement, she would wait a night until they too could share in the Sensurround experience. One friend, she said, "woke up in the morning and said Alex sounded like he was putting a cat through the wood chipper."
Mr. Fantoni, 45, a real estate agent from Oradell, N.J., has always snored. His college roommate made a habit of throwing a penny at him every time Mr. Fantoni woke him up with his snore. One morning Mr. Fantoni had been pinged with 35 coins.
The snore grew worse with age, until it was "rip snorting, with no rhythm to it at all," Ms. McCafferty said. About five years ago she started tramping off to the spare room. Mr. Fantoni found himself waking up with headaches and falling asleep when he drove. Twice he woke up gasping for air. He had sleep apnea.
"He would say, 'You have no idea what it's like not to be rested,' " Ms. McCafferty said incredulously. " 'Yes,' I would say, 'I have a very good idea what it's like.' "
He had his uvula removed to no avail. Then he visited the sleep center at Holy Name Hospital in Teaneck, N.J., where he got a continuous positive airway pressure machine. A mask now blasts air into his nose all night. That has worked well, he said.
"We're back together in the same bedroom," she said. "Most nights."

Very good article.

thanks for posting it.

I have seen several articles about the problem of snoring and its indication of apneas recently. Up until the last 6 mos/year I don't EVER remember hearing or reading anything about it. Or was I just not paying attention?

When I think of the years my precious wife has endured my (reportedly) seismic snoring... To have that stopped is THE biggest benefit I have found from this CPAP stuff. Yes, I do feel better, but not giddy like some here have reported, but by using the full face mask she can sleep in peace. That's enough for me!

Clif