Keisha Brown, Saturday Life Writer

Girls, does your beloved keep you awake half the night with his powerful snoring? Does he occasionally wake up gasping for air? Do you wake up miserable and tired while he has had a restful sleep?

The difference between snoring and obstructive sleep apnea is a matter of degree. A snorer makes everyone else in the house miserable but sleeps well and generally has no ill-health effects as a result. A person with obstructive sleep apnea (OSA) makes everyone else in the house miserable, sleeps poorly and (if the OSA is sufficiently severe) may develop high blood pressure, bed wetting (not just in children!), right-sided heart failure and pulmonary hypertension (high blood pressure in the pulmonary vessels).

Persons with even moderately severe OSA have an increased risk of dying prematurely of heart attack, stroke or an accident (for example, by falling asleep behind the wheel).

Innocent snorer

Snoring is usually due to 'rattling' of the uvula and soft palate against the back of the throat during inhalation. OSA is a more extreme problem. In some patients, the uvula and soft palate block the airway, while in other patients, the tongue falls backward, blocking the airway.

Still, others have obstruction at both levels. The person is unable to take a breath and may struggle mightily. This wakes the person, who catches his/ her breath (often with a loud gasp), then goes back to sleep without realising that he/she was ever awake. In patients with extremely severe OSA, this process may repeat 100 or more times each hour!

Persons with OSA often (but not always) complain of daytime sleepiness. However, many patients come to medical attention only because their spouses/significant others are frightened by the nocturnal airway calisthenics. You might think it would be easy to determine who has OSA and who is just an 'innocent snorer', based on the description provided by the spouse or the patient ... but it is not at all easy. The only way to make this determination is with a sleep study ('polysomnogram' or PSG).

Shallow breathing

During a sleep study, the patient is connected to a variety of monitors, which record the electrocardiogram (electrical activity of the heart), electroencephalogram (electrical activity of the brain), pulse, respiratory rate and oxygen saturation (the amount of oxygen in the blood).

A wealth of information is derived from the sleep study. How many apneas does the patient have per hour, and how many hypopneas per hour? (Hypopneas are episodes of dangerously shallow breathing, but breathing does not cease, as it does in apnea.) How often does the patient's blood oxygen content drop to dangerous levels, and how low does it get? Does the patient have any heart-rhythm problems during sleep? How poorly does the patient sleep? Most important, does the patient have obstructive sleep apnea?

If you suspect that either you or your spouse/significant other may have obstructive sleep apnea, see an ear, nose and throat specialist (ENT specialist) as soon as possible. He will be able to evaluate and treat you for OSA.