Sounds Of Sleep

Marcel Ascue used to snore so loudly that his 5-year-old son Nathan made a joke of ZZZing whenever he came near. Tired of being a punch line (and just plain tired), Ascue, 44, finally went to the doctor and found he had sleep apnea. Last month he started sleeping with a mask, hooked to an air pressurizer, that covers his nose and forces a steady stream of air down his throat. The jokes haven't stopped yet--now his wife quips that she's sleeping with Darth Vader--but at least the snoring has.

Ascue's story might amuse people who don't snore or have bed partners who do. But that's not many people. By 50, half of men and a quarter of women snore; 10 to 20 percent of Americans seek treatment for snoring each year. The numbers are expected to jump as baby boomers age, since snoring is a side effect of growing old, gaining weight and losing muscle tone. During the day the brain keeps the throat muscles taut and the airway open. When sleep descends, the muscles relax and vibrate as air rushes by. Most snorers have airways that are naturally small or partially blocked by the tonsils, soft palate or the uvula, the floppy tissue that hangs in the back of the throat. The obstructions make the vibrations louder.

For "simple snorers," the nightly noisemaking is merely a nuisance. But in a third of cases, it's a sign of sleep apnea, in which a faulty feedback loop between the brain and the respiratory system lets the airway completely collapse until the brain registers low oxygen levels and jerks the patient awake. The constant jump-starts, which can happen as often as once a minute, send the heart rate on a roller coaster. Recent research shows that apnea is a risk factor for cardiovascular disease on par with high cholesterol, smoking and obesity.

Apnea sufferers need medical help; too often, though, they self-medicate with over-the-counter snoring remedies like nasal sprays or strips that quiet the snores without curing the apnea. Even some doctors confuse the two ailments. Daniel Loube, associate director of the Sleep Medicine Institute at Swedish Medical Center in Seattle, says surgeons sometimes treat apnea by cutting away tissue in patients' throats, "thinking they're helping people." They're not. The airway can still collapse.

Ascue's cure, on the other hand, is 100 percent effective. The most commonly prescribed apnea treatment, it's called CPAP, or continuous positive airway pressure. CPAP is neither comfortable nor portable, unfortunately. Patients who don't want to be bothered can elect surgery to expand the airway by pulling the jaw forward, or use retainer-type mouth guards to achieve the same result. Recently scientists found that speeding up the heart rate with a pacemaker can correct apnea. The trouble is, no one knows why it works. But there's also an effective low-tech cure: weight loss. With the flab goes the floppy tissue. No doubt bed partners appreciate the disappearance of both.