Men — and women — may be at increased risk for heart attack, stroke and more

Snoring may not strike you as a serious health problem. But that belief could cause you to unwittingly increase your risk for a variety of medical conditions, including some that are life-threatening.

It’s been known for some time that the sleep disorder sleep apnea — commonly marked by snoring — is associated with an increased risk for cardiovascular disease, heart failure and stroke. Recent scientific evidence now links sleep apnea to erectile dysfunction and even eye disorders, such as glaucoma.

Latest news: New treatments are relieving sleep apnea symptoms at an unprecedented rate.

ARE YOU AT RISK?

Up to 20 million Americans — including one in every five adults over age 60 — have sleep apnea, a condition in which breathing intermittently stops and starts during sleep. Most people who have sleep apnea snore — but not all snorers have sleep apnea.

And contrary to popular belief, sleep apnea also can affect women. About 9% of middle-aged women have the disorder and 24% of middle-aged men.

EVEN MILD CASES ARE DANGEROUS

Doctors once thought that only severe forms of sleep apnea posed cardiovascular risks. Now, research shows that patients who stop breathing more than five times an hour have double or even triple the rate of hyper­tension as those who breathe normally. With sleep apnea, breathing may stop several dozen or even hundreds of times during the night compared with one to four times an hour during sleep in a healthy adult. The frequent interruptions in breathing that characterize sleep apnea can lead to a potentially harmful decrease in oxygen levels.

WHAT CAUSES SLEEP APNEA

It’s not widely known, but there are two forms of sleep apnea…

Obstructive sleep apnea (OSA), the most common form, occurs when the muscles of the throat relax and collapse during sleep, interrupting the flow of air.

Obesity is a main cause of OSA. Fatty deposits surrounding the airways may interfere with breathing, and the weight of excess tissue makes it harder for muscles to retain their normal position during sleep. People with large neck sizes (17 inches or more for men, 16 inches or more for women) are at increased risk.

Central apnea, in which the brain doesn’t send the appropriate signals to the respiratory muscles, is relatively rare. It is not associated with obesity and sometimes occurs in the presence of a stroke, which affects brain function.

BEST TREATMENT OPTIONS

Patients who are slightly overweight and suffer from mild OSA (defined as five to 15 interruptions in breathing per hour) may improve if they lose just a few pounds. Most patients, however, need medical help. Best approaches for both types of apnea…

Change sleep position. Up to 50% of patients with mild OSA and 20% of those with a moderate form of the disease (16 to 30 interruptions in breathing per hour) stop breathing only when they sleep on their backs. This form of OSA, positional sleep apnea, can be completely eliminated if the sufferer sleeps on his/her side or stomach.

New development: A product called Zzoma, which is worn around the chest like a belt, has a padded back that prevents people from sleeping on their backs. Developed by researchers at Temple University School of Medicine, Zzoma has been approved by the FDA for patients diagnosed with “positional snoring.” It is available at www.zzomasleep.com. Cost: $69.95.

Other treatments (all are available at medical-supply stores)…*

Continuous positive airway pressure (CPAP). This is the standard treatment for OSA and central apnea. How it works: CPAP delivers room air under pressure through a mask to a patient’s nose and/or mouth. The slightly pressurized flow of air helps keep the airways open and helps prevent snoring as well as apnea.

CPAP can be uncomfortable because patients must wear a mask all night. For this reason, the device is used as prescribed — for example, worn all night, every night — only about half of the time.

Helpful: Before choosing a CPAP device, try on different masks until you find one that’s comfortable enough to wear all night. Typical cost: Starting at about $200.

Alternative: Some people with mild OSA prefer to wear a nighttime oral device, such as the Thorn­ton Adjustable Positioner (TAP), which moves the lower jaw forward so that the tongue and throat tissue don’t block the airway. The TAP is available online for about $1,800.

Bi-level positive airway pressure (BiPAP) is similar to CPAP, except the machine delivers more air pressure when patients inhale and less when they exhale. This is helpful for OSA patients who find it uncomfortable to exhale “against” air pressure — and for obese patients who tend to breathe too shallowly. Cost: Starting at about $800.

Adaptive servo-ventilation (ASV) is a newer air-flow approach that also involves wearing a mask. An ASV unit, which is used for central apnea, analyzes normal breathing patterns and stores the data in a computer. If a patient stops breathing, the machine automatically delivers pressurized air — and then stops when the patient’s normal breathing resumes. Cost: About $7,000.

IF YOU STILL NEED HELP

For most sleep apnea patients, surgery is a last resort. It makes a significant difference in only 20% to 30% of cases.

Common procedures…

Uvulopalatopharyngoplasty (UPPP) involves removing tissue from the back of the mouth and the top of the throat. This procedure often stops snoring, but is less effective at eliminating frequent interruptions in breathing during sleep.

The Pillar, a relatively new procedure, involves the placement of small synthetic rods in the soft palate in the mouth. The rods stiffen the tissue and reduce sagging during sleep. Like UPPP, it’s effective primarily for snoring.

*You should undergo a sleep evaluation at a sleep disorders clinic before buying one of these devices. Insurance won’t pay for the device unless you’ve been diagnosed with sleep apnea by a doctor. To find a sleep disorders clinic near you, consult the American Academy of Sleep Medicine (708-492-0930, www.aasmnet.org).