Ask the Doctors 3/12

Dear Doctors: My husband has always snored, but lately it’s gotten a lot worse. Would gaining weight have anything to do with it? He just turned 67 and put on about 12 pounds during the pandemic. Sometimes his breathing stops, and I’m worried it might be sleep apnea. How do we find out?

Dear Reader: It’s estimated that at least half of all adults snore on occasion, and up to one-fourth are regular snorers. As people reach older age, these percentages rise.

When someone snores, it means the air they inhaled is meeting resistance within the throat as it moves to the trachea. Sources of obstruction include the tongue and the various tissues of the throat, which relax during sleep. These tissues can sag enough to narrow, or even block, the various passageways leading into and out of the pharynx – that’s the throat – and thus impede airflow.

Sleeping on the back increases the risk of this type of blockage. Other factors in snoring can include an oversized uvula, the loss of muscle tone associated with aging and the presence of mucus due to illness, allergy, certain medications or sinus infection.

You mentioned that your husband has recently put on a few pounds. Unlike in women, who tend to gain weight below the waist, fat distribution in men favors the abdomen, upper torso and neck. The location of this excess weight can also play a role in snoring, and it is one of the reasons that twice as many men as women snore.

Whatever the cause, this narrowing of the air passages means that suction gets created each time someone breathes in. That sets the soft, moist and sometimes floppy tissues within the throat to vibrating, which results in the sounds of snoring as air moves through.

Snoring is an annoyance to the person listening and a potential health hazard to the person doing it. This goes beyond the interruption to high-quality sleep that snoring can cause. Prolonged snoring can lead to morning headache, a dry or scratchy throat, poor concentration and daytime sleepiness. Snoring is also linked to elevated blood pressure.

Some people who snore may suffer from the condition you asked about, which is obstructive sleep apnea. It’s a potentially serious sleep disorder that involves repeated episodes during which airflow is completely blocked. Symptoms include very loud snoring, suddenly gasping for air during sleep and moments during which breathing is reduced or even stops altogether. Sleep apnea can increase the risk of developing atrial fibrillation, cognitive and behavioral disorders, cardiovascular disease and metabolic disorders, such as Type 2 diabetes.

Diagnosis begins with a physical exam and a complete medical history. If sleep apnea is suspected, then a sleep study with either an at-home test or at a sleep lab may be ordered. Treatment can range from lifestyle changes such as losing weight and changing sleep positions and habits to the use of breathing devices designed to keep the airways open.

Considering your husband’s symptoms, age and weight gain, it would be wise for him to see his doctor for a diagnosis.

Send your questions to askthedoctors@mednet.ucla.edu.