Dictation & Shadowing
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Part 10: Test 07 - Part C - Extract 2

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Dictation

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Hello,I'mJamesTradello,asleep
whospecializesinupperairwayphysiology.
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Test 07 - Part C - Extract 2

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Hello, I'm James Tradello, a sleep physician who specializes in upper airway physiology.

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While snoring can be frustrating for those who have to listen to it,

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it is also known to contribute to a range of health problems.

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There's now also an emerging line of research that suggests snoring may directly contribute to serious cardiovascular health problems.

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When we go to sleep, the muscles of the upper airway relax,

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causing it to become floppy and partially collapse.

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This occurs to some extent in all of us.

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However, in some people the airway is excessively narrowed,

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particularly at the level of the tongue and uvula or soft palate.

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As we breathe in, we produce suction pressure to draw air into the lungs.

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This further narrows the airway,

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similar to when a person sucks too hard on a straw,

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and can cause upper airway tissues such as the soft palate to vibrate or flutter,

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similar to a flag in the wind.

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This movement creates the noise of snoring.

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There are many triggers for snoring.

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If a person doesn't normally snore, alcohol can be a key trigger as it blocks the nose and can contribute to relaxing of the airway muscles.

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And if a person already snores, alcohol is likely to make their snoring a lot louder.

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Being overweight increases fat around the neck, compressing and narrowing the throat.

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But thin people do snore too,

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and many who are overweight do not.

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A blocked nose due to a cold, allergies, polyps or anatomical abnormality

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creates the need for greater suction pressure to draw air into the lungs when breathing,

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which further narrows the airway.

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Mouth opening often occurs when the nose is blocked during sleep,

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which itself can cause snoring.

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Via airway, anatomy and pressure changes.

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Sleeping on the back contributes to collapse of the airway,

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as gravity pushes the tongue and soft palate towards the back of the throat.

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Enlarged tonsils narrow the airway and are a primary cause of snoring in children.

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In terms of the effects that snoring can have on a person's well-being,

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it can create a dry mouth, sore throat, or headache,

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and can leave a person feeling tired.

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It can play significant strains on personal relationships,

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particularly a person's bed partner,

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but also those sleeping in an adjacent room or even sometimes on the other side of the house.

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Snoring forces many couples to sleep in separate bedrooms, disrupting intimate bonds.

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Snorers are often embarrassed to sleep among others,

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promoting anxiety and hindering their social relationships.

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Sleep disruption caused by snoring can make someone and others cranky and irritable during the day,

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but also may lead to impaired memory, concentration and learning difficulties,

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and obesity and reduced immunity.

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More serious consequences include snoring as a possible marker for obstructive sleep apnea,

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a disorder where the upper airway repeatedly closes during sleep

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and breathing stops for at least 10 seconds at a time.

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Obstructions to breathing can sometimes last for more than a minute

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and occur over 100 times an hour,

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starving the body of oxygen and fragmenting sleep.

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Obstructive sleep apnea sufferers are often excessively sleepy and at greater risk of car and industrial accidents,

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and cardiovascular diseases like high blood pressure, heart attack, and stroke.

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Over the last decade, research has suggested heavy snoring itself may be a direct cause of cardiovascular complications,

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particularly a condition known as carotid artery atherosclerosis.

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When affected by atherosclerosis, fatty deposits known as plaques form in the wall of the artery.

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Over time, they can cause the blood vessel to narrow and limit blood flow to the brain.

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One study has shown that snoring vibrations are transmitted to the carotid artery,

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which can damage its wall and lead to the development of atherosclerosis.

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Subsequently, snorers may rupture a formed plaque,

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resulting in pieces of the plaque moving through the bloodstream and blocking small vessels in the brain.

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However, additional research is required to bring further clarity to this hypothesis.

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Given the multiple causes of snoring,

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there are numerous potential treatments available that work for some people, but not others.

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Recommended lifestyle changes that work for some patients may include

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avoiding alcohol before bed and avoiding sleep deprivation,

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losing excess weight and stopping smoking.

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There are several medical treatments for snoring that require professional advice.

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If you treat patients that snore regularly,

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it is highly recommended they see a sleep and respiratory doctor for diagnosis

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and to determine the right kind of treatment.