The sleep solution

Sleepless nights next to a snoring spouse have spurred many people to send their loved one to the doctor. But patients seeking help for their snores should be careful about the advice they receive.

“A substantial number of sleep apnea sufferers are misdiagnosed as [simply] snorers,” says Gabriele Barthlen, director of the sleep center at Mt. Sinai Hospital in New York. Instead, they may have obstructive sleep apnea, which can lead to high blood pressure and heart problems if left untreated.

In sleep apnea, the airway becomes blocked during sleep, causing the person to snore or repeatedly wake up. The two main symptoms are daytime sleepiness and snoring. However, only a small percentage of the 30% to 50% of the population who snore actually has the disorder. So doctors must figure out whether a patient needs treatment for apnea or for snoring.

The gold standard for diagnosing the disorder is polysomnography, an overnight sleep test that measures airflow, oxygen saturation, snoring and brain activity. But some doctors have adopted an easier alternative -- assessing a patient’s medical history for risk factors such as obesity, and physically examining the patient’s airway for signs of obstruction.

A new study shows this method just doesn’t work. Barthlen and collaborators in Germany studied 101 patients who complained of snoring. The team measured nose and throat anatomy in each patient and then gave them an overnight sleep test. The team found there was no significant anatomical difference between those diagnosed with apnea and those who merely snored.