The Allergist

The Allergist

Workplace Treatment Role

Many workplaces sponsor Employee Assistance Programs that offer short term counseling and or assistance by connecting employees with drug or alcohol problems to local treatment resources, including peer support and recovery groups. Therapeutic work environments that provide employment for individuals who abuse drugs but demonstrate abstinence promote the lifestyle without drugs and help improve job skills, punctuality and other behaviors necessary for active employment. To implement this type of work environment, companies need access to testing facilities, trained personnel and workplace monitors.

Is Snoring a Problem?

Snoring occurs when there is a narrowing or partial blockage of the air­ways at the back of the mouth and upper throat. This obstruction results in increased air turbulence when breathing in, causing the soft tissues in the throat to vibrate. The result is a noisy snore that can disrupt sleep. When the soft palate, tongue and throat relax, the airways at the back of the mouth become narrow. Allergies or sinus problems can also contribute to a narrowing of the airways, as can being overweight and having extra soft tissue around the upper airways.
Long the material for jokes, snoring is common (and annoying) in adults. However, snoring is no laughing matter. Frequent, loud snoring is often a sign of sleep apnea and may increase the risk cardiovascular disease and diabetes, as well as lead to daytime sleepiness and impaired performance.
The larger the tissues in the soft palate, the more likely a person is to snore while sleeping. Alcohol or sedatives taken shortly before sleep also promote snoring. These drugs cause greater relaxation of the tissues in the throat and mouth. Surveys reveal that about one-half of all adults snore and 50 percent of these adults do so loudly and frequently. African Americans, Asians and Hispanics are more likely to snore loudly and frequently compared to Caucasians. Snor­ing problems increase with age.
Not everyone who snores has sleep apnea, but people who have sleep apnea typically do snore loudly and frequently. Sleep apnea is a serious sleep disorder and its hallmark is loud, frequent snoring linked to intermittent brief pauses in breathing while sleeping. Even if a person does not experience these breathing pauses, snoring can still be a problem for individuals as well as for bed companions. The increased breathing effort associated with snoring can impair sleep quality and lead to many of the same health consequences as sleep apnea.
One study found that older adults who did not have sleep apnea, but who snored at least six nights a week, were more than twice as likely to report being excessively sleepy during the day than those who never snored. The more people snored, the more daytime fatigue the reports showed. That sleepiness may help explain why snorers are more likely to be in car crashes than people who do not snore. Loud snoring can also disrupt the sleep of companions and strain marital relations, especially if snoring causes the spouses to sleep in separate bedrooms.
Snoring also increases the risk of developing diabetes and heart disease. One study found that women who snored regularly were twice as likely as those who did not snore to develop diabetes, even if not overweight. Other studies suggest persistent snoring may raise the lifetime risk of developing high blood pressure, heart failure and stroke.
About one-third of all pregnant women begin snoring for the first time during the second trimester. Women should let a doctor know if snoring occurs during pregnancy. Snoring during pregnancy can be associated with high blood pressure and can have a negative effect on the growth and development of the baby. A doctor will routinely keep a close eye on the blood pressure of a pregnant throughout the pregnancy and can let the woman know if any additional evaluations for the snoring might be use­ful. In most cases, the snoring and any related high blood pressure will subside shortly after delivery.
Snoring can also be a problem in children. As many as 10 to 15 percent of young children that typically have enlarged adenoids and tonsils snore on a regular basis. Several studies show that children who snore (with or without sleep apnea) are more likely than those who do not snore to score lower on tests that measure intelligence, memory and ability to maintain attention. These children also have more problematic behavior, including hyperactivity. The result is that children who snore do not perform as well in school as those who do not snore. Strikingly, snoring relates to a greater drop in IQ, comparatively, than seen in children who had elevated levels of lead in the blood system. Although the behavior of children improves after the snoring stops, studies suggest that children may continue to get poor grades in school, perhaps because of lasting effects on the brain linked to snoring. Doctors should evaluate a child if the child snores loudly and frequently (three to four times a week), especially if brief pauses in breathing while asleep occur and if there are signs of hyperactivity or daytime sleepiness, inadequate school achievement or slower than expected development.
Surgery to remove the adenoids and tonsils of children often can cure snoring and any associated sleep apnea. Such surgery suggests a reduction in hyperactivity and improved ability to pay attention, even in children who showed no signs of sleep apnea before surgery.
Snoring in older children and adults may be relieved by less invasive measures, however. These measures include losing weight, refraining from tobacco, sleeping on the side rather than on the back or ele­vating the head while sleeping. Treating chronic congestion and refraining from alcohol or sedatives before sleeping can also stop a person from snoring. In some adults, snoring dental appli­ances that reposition the soft tissues in the mouth can prevent snoring. Although numer­ous over-the-counter nasal strips and sprays claim to relieve snoring, no scientific evidence supports those claims.