& Sleep

Understanding the causes
& health consequences

Snoring is simply the first and most obvious sign that the airway is closing down. Snoring occurs due to vibration of relaxed (floppy) tissues in the airway. While often the subject of jokes, snoring is the early warning signal for sleep apnea. Typically snoring and sleep apnea are affected by three major factors: genetics (size of your airway), age, and weight / lifestyle choices. While we cannot do anything about the genetics and aging, maintaining a healthy lifestyle including a good diet and exercise combined with limiting the use of alcohol and/or smoking, certainly will always have a positive effect.

Sleep apnea is a term that describes the health condition where the airway is completely closing off for periods of time during which no breathing is occurring. A temporary state of asphyxiation. While obstructive sleep apnea as described is more common, there is also a condition called Central Sleep Apnea which occurs if your brain doesn't send proper signals to the muscles that control your breathing.

The cycle of apnea:

  1. The apneic patient falls asleep
  2. Muscle tone in the body relaxes
  3. Airway narrows and/or collapses, causing breathing to be difficult or impossible
  4. The collapse of the airway may cause loud snoring, snorts, pauses in airflow, and labored breathing
  5. Oxygen levels begin to fall
  6. The apneic patient continues to struggle for breath. Time goes by... 10, 20, 40 seconds, and longer
  7. Heart rate falls below normal—there is decreased oxygen to pump through the body
  8. Brain senses low oxygen/high carbon dioxide level, releases jolt of adrenaline-"fight or flight" response—to awaken brain and body and prevent suffocation
  9. Sleeper awakens briefly, takes five or six large breaths, breathing in oxygen and blowing off excess carbon dioxide (CO2). Sleeper typically does not remember arousal. Sleeper often repositions him or herself on the bed
  10. Heart rate speeds up in response to rush of adrenaline—now pumps above normal heart rate
  11. Oxygen/carbon dioxide levels return to near normal. Brain allows sleeper to resume sleeping
  12. Sleeper falls asleep
  13. Muscle tone relaxes. Cycle repeats

Sleep Apnea: Phantom of the Night

It is not unusual for an apneic patient to have over one hundred arousals per night due to apnea, though he or she most likely will not remember any of them. This makes apnea suffers—especially those who live alone or sleep in bedrooms separate from their partners—vulnerable to not having their condition diagnosed for many years, if ever. Severity of sleep apnea is generally measured by number of times you stop breathing at night and for how long.

"The Bad News" Common symptoms of sleep apnea include:

  1. Loud Snoring
  2. Choking or Gasping During Sleep
  3. Excessive Daytime Sleepiness
  4. Weight Gain
  5. Decreased Energy and Mood
  6. Sleep Apnea is associated with long term health and safety concerns including:
    1. Heart Attack and Stroke
    2. Diabetes
    3. High Blood Pressure
    4. Weight Gain
    5. Mood Disorders: Anxiety and Depression
    6. Memory and Concentration Issues
    7. Car and Work Related Accidents
    8. Decreased Sex Drive

Health risk statistics for obstructive sleep apnea include:

  • Mortality Risk: Moderate to severe OSA was associated with 33% mortality over 14 years compared to 7.7% mortality in people with no sleep apnea.
  • Stroke Risk: 65% 0f stroke patients have sleep disordered breathing.
  • Hypertension: 43% of patients with mild OSA and 69% of patients with severe OSA have hypertension.
  • Diabetes: Sleep disordered breathing is an independent risk factor for insulin resistance.
  • Moto Vehicle Accident: People with moderate to severe sleep apnea have an up to 15-fold increase of being involved in a traffic accident.
  • Healthcare Resources: Undiagnosed patients used $200,000 more in the two-year period prior to diagnosis. Total economic cost of sleepiness = approximately $343 - $56 billion.

"The Good News" Sleep Apnea is easily treated, and once treated most health and safety risks come back to normal levels. That being said depending upon the severity of the sleep apnea, the span of time during one's life while suffering from sleep apnea can certainly leave lasting consequences, which put simply can shorten your lifespan and decrease quality of life.

How do they screen and test for sleep apnea?

  • Sleep Questionnaires such as the Epworth Sleepiness Scale and the STOP Questionnaire are common screening tools. The Epworth scale investigates how sleepy the individual is during the day using this as an indication of sleep apnea. Where the STOP Questionnaire focuses on snoring, pauses in breathing, sleepiness or fatigue during the day, and high blood pressure.
  • Sleep Testing is performed using technology that ranges from simple at home testing devices, through to more complex sleep systems that are used in sleep laboratories under the direction of medical sleep specialists and sleep technologists.

Snoring Therapy Options:

  • Lifestyle: Your first a most accessible potential fix for the snoring is to evaluate your lifestyle and make changes to positively affect weight, and to reduce the use of alcohol and tobacco products. We understand that these choices and adjustments are not easy to make.
  • Over-the-counter products: There are a great many different ways that people may try to reduce or eliminate snoring. Typically the products can be grouped into the following categories affecting:
    1. Sleep position (ex. pillows)
    2. Nasal breathing (ex. nose strips, sprays)
    3. Airway (ex. boil & fit oral appliance)
    4. Sleep partner (ex. ear plugs, sleep aids)
    5. Lifestyle (ex. diet & fitness)

Depending upon the snoring level and underlying airway issues often a level of success can be achieved.

Sleep Apnea Therapy Options:

Lifestyle: the Canadian Lung Association provides the following guidance "Some people with mild OSA can improve their symptoms by making some changes. In some people, these changes will be enough to treat their sleep apnea symptoms:

  • Lose weight. Overweight people can have extra tissue around their necks- this tissue can block their airway. By losing weight, you can shrink the tissue around your airway, and allow more air to pass to your lungs. Studies show that people who lose 10% of their weight can have a 30% decrease in their sleep apnea symptoms.
  • Avoid alcohol and sedatives (medicines that make you sleepy). Alcohol and sedatives can make your throat muscles relax too much, allowing your airway to close off. If you avoid alcohol and sedatives, you may be able to keep your airway open.
  • Sleep on your side, not your back. Some people only get obstructive sleep apnea when they sleep on their backs. Sleeping on your back lets gravity pull on the tissues at the back of your throat and neck. This can make your airway narrow or make it collapse completely. You can train yourself to sleep on your side by:
    • putting pillows against your back to prop yourself on your side.
    • using the "tennis ball trick": sew a pocket onto the back of your pajama top and put a tennis ball in it. If you start to roll to your back during sleep, the pressure from the ball will make you roll back onto to your side."

With any therapy intervention for sleep apnea, the involvement of physicians and other health professionals to properly diagnose and manage your therapy choices and their effectiveness is recommended.

Snoring products

  • Nose Strip
  • Herbal Sprays
  • Ear Plugs
  • Pillows
  • Sleep Aids
  • Lifestyle:
    1. Weight Loss
    2. Fitness
    3. Diet & Nutrition
    4. Vitamins and Supplements

Sleep apnea products

  • Nose Strip / Sprays / Pillows
  • Lifestyle
  • Weight Loss
  • Fitness
  • Diet & Nutrition
  • Vitamins and Supplements

Online sleep apnea screening - Think you might have sleep apnea?

STOP Questionnaire:

Obstructive Sleep Apnea (OSA) Questionnaire

Please Answer ALL Questions.

Question #1

Do you snore loudly (louder than talking or loud enough to be heard through closed doors)?


Question #2

Do you often feel tired, fatigued, or sleepy during the daytime?


Question #3

Has anyone observed you stop breathing during your sleep?


Question #4

Do you have or are you being treated for high blood pressure?


"In Your Community" - Professional Help Options

Physician - a physician can help you assess concerns about sleep apnea and your individual health circumstances. While general physicians are not involved in the direct provision of therapy, their guidance and referral of patients for sleep study, sleep specialists, and treatment are key building blocks to successful therapy. Options include:

  • Family Physician
  • Walk In Clinic

Content provided by Dr. Halstrom Sleep Apnea & Snoring Clinics.

About Dr. Halstrom - dentist Dr. Wayne Halstrom is an inventor, clinician, and true pioneer within the field of oral appliance therapy for sleep apnea and snoring. He graduated from the University of Alberta with his D.D.S. in 1960, after obtaining his B.A. from the University of Saskatchewan in 1956. He maintained a practice in North Vancouver, B.C. from 1961 to 1991. Since 1991, Dr. Halstrom has solely focused his practice to the treatment of Snoring and Sleep Apnea. He is a Past-President of The Canadian Dental Association (CDA) and The Association of Dental Surgeons of British Columbia (BC Dental Association). Currently an Adjunct Professor, Respiratory Therapy at Thompson Rivers University, Dr. Halstrom has also served with the University of British Columbia as a part-time clinical instructor in the Department of Prosthodontics at various times over the years. Prior to his position of Diplomate of the American Board of Dental Sleep Medicines, he was a member of the Joint Medical-Dental sleep research team from 1989 to 1993, and carried a rank of Clinical Assistant Professor.

As a visionary and leader Dr. Halstrom has traveled the world speaking to health professionals on how best to offer therapy to one of the world's most serious undiagnosed medical conditions.