Snoring alone: Sleep apnea, restless legs syndrome can make it hard for significant others to share same bed

Linda Wendel discovered distance was the key to dealing with her husband’s loud snoring.

Dan Wendel snored even when they married eight years ago, she said. But when it got worse, and the self-described light sleeper couldn’t get the rest she needed, she used a move to a new house in Lisbon, N.D., years ago as a chance to do something about it.

“I told him, ‘You can just sleep in the basement. I don’t need this,’ ” she said.

The couple slept alone, Dan in the basement and Linda in an upstairs bedroom. Despite her complaints, nothing changed.

“There was just no way that you could sleep in the same room as him,” she said.

But that changed about five years ago, a combination of several things that Linda Wendel said were finally enough to get her husband to take it seriously and schedule an appointment that would diagnose him with obstructive sleep apnea.

“It was night and day,” she said about the change she witnessed in Dan, thanks to the help of a continuous positive air pressure (CPAP) machine after diagnosis.

Shaun Christenson, a neurologist and sleep disorder specialist at Essentia Health in Fargo, said cases like the Wendels’ are fairly common – and often only come to the attention of medical professionals after tough love from the bed partners who lose sleep to their loved one’s snoring, obstructive sleep apnea, nighttime kicking and nudging caused by restless legs syndrome or other sleep disorders.

“It’s their partner that’s telling them to go see the doctor, because the snoring is so loud and disturbing they’ll say they’ve got to see a doctor and there’s something wrong,” he said.

LOSING SLEEP

More than half of middle-age and older adults snore, and many of those suffer from obstructive sleep apnea, according to Dr. Samy Karaz, a physician and medical director of Sanford Health’s Sleep Medicine Center in Fargo.

Men are the most frequent offenders, he said, though women tend to catch up after menopause because higher testosterone levels can result in more accumulation of fat and muscles in the neck, crowding the throat and putting extra pressure on the soft throat muscles.

But while related, sleep apnea is much more than the loud snoring that can be one of the most obvious symptoms.

Karaz said when people are awake, their throat muscles are always stretched open, which opens the airway – and keeps our daytime breathing quiet. But once we fall asleep, these muscles start to relax, narrowing the airway and causing snoring.

Apnea takes it one step further, closing the throat entirely during sleep – which is why sufferers will actually stop breathing for short periods of time, then usually snort or gasp for air.

The noise can be enough of a hassle for bed partners, Karaz said. But they also face high anxiety, he said, with some worrying their loved one won’t start breathing again unless they nudge them awake.

“Many of them really worry that the person who has the pausing might die, or wonder will he die if he quits breathing,” he said.

Though it’s “extremely rare” for someone to die from sleep apnea, he said it can lead to medical woes for those who suffer from it. If left untreated, it shortens a sufferer’s lifespan by an average of five years and drastically increases the risk of hypertension, diabetes, heart attack, stroke, depression and obesity – and being overweight can make it worse, expanding the fat cells in the neck and further narrowing the airway.

“It becomes a vicious cycle,” he said. “They have apnea, they sleep poorly, they eat more, they get more obese, and they have more apnea.”

The apnea sufferer may not realize it, but their condition also makes it nearly impossible to get quality sleep – no matter how many hours they spend in bed each night.

A healthy person will spend 95 percent or more of their sleep in the deeper sleep stages to get proper rest, Karaz said. But apnea sufferers’ brains have to wake up from sleep tens, or even hundreds, of times each hour to open up the throat, meaning they rarely get deep sleep.

“It’s like a diver being pulled out of the water repeatedly, so they never have a chance to reach deep sleep and stay in deep sleep,” he said.

Many will end up with chronic daytime sleepiness, struggling to stay awake when they sit down and finding it hard to focus at work, he said – though many don’t realize what they’re missing out on because they’re so used to their condition.

PILLOW TALK

Dan Wendel had several warning signs, including waking up with a sore throat every morning and finding it difficult to get the energy to help his wife with their young kids or household chores. He was groggy at work, but said he figured he was just like everyone else.

The issue came to a boiling point about five years ago, when he went to a fishing tournament with relatives and shared a cabin for the overnight trip.

“That night, I kept up the entire cabin,” he said.

Dan Wendel’s uncle confronted him the next day, saying he was the loudest snorer he’d ever heard, and suggested he should go to a doctor.

That experience, along with his wife’s urging and suspicion that his symptoms could be caused by depression, finally got him to go for help – reluctantly.

“I thought I’d do it just to get people off my back,” he said.

With the referral of his primary-care physician, Wendel spent a night at Sanford’s sleep clinic, and specialists hooked him up to a CPAP machine to see if it would help.

“I woke up from my test, and I remembered the dream that I had just sleeping in the center,” he said. “I hadn’t dreamt and remembered a dream in three or four years.”

Now, Dan Wendel is a faithful user of the CPAP machine that uses a continuous stream of low air pressure to keep the airway open, helping him get good sleep – and putting an end to his snoring that had kept him apart from his wife at night.

“You didn’t get the pillow talk at night and stuff like that,” he said. “But every night now before we go to bed, we always talk through our days and talk about whatever happened. That’s kind of nice.”

Linda Wendel said she had learned to deal with the snoring before, but she appreciates having her husband alert and energetic again because he’s now able to help her with chores, caring for their three children or even just stay awake on long drives.

“It’s just nice to not have him basically only physically present,” she said. “Even though he was sitting there in a chair, to me it didn’t count when he wasn’t interacting.”

When sleep apnea, restless legs syndrome, sleepwalking or other nighttime conditions prevent a bed partner from getting their sleep, too, Christenson said it can lead to frustration, anxiety and even embarrassment if the couple has to sleep in separate beds.

But rather than ignoring the warning signs and letting things get to a breaking point after years of restless nights, he said people should listen to their loved one’s concerns and consider talking with their physician to see if they could benefit from treatment.

“If it is to the point where your significant other or spouse is kicking you out of the bed, that means it’s a pretty significant problem,” he said.

Readers can reach Forum reporter Ryan Johnson at (701) 241-5587