Is Your Snoring a Warning Sign?

Ade Mardiyati | August 24, 2011

For as long as he can remember, Hector Siagian has been told that he snores when he sleeps. Loudly. The 41-year-old banker said his snoring got worse after he got married, and as he gained weight.

“It was so bad that my wife had to cover her ears with headphones during the first year of our marriage. But now that she’s used to it, she doesn’t do that anymore,” said Hector, who is up to 100 kilograms.

Three years ago, the father of three had a stroke. “It has been three years but it still affects me physically. Every time I feel tired, my body feels numb. I almost can’t lift anything with my hands because they feel so heavy,” he said.

But despite all his health problems, Hector doesn’t think they’re related to his snoring. “I think I only snore when I feel tired from work,” he said. “It also depends on my sleeping position. When I lie on my back, I snore. I’m sure if I can lose weight, I will stop snoring.”

Andreas Prasadja, a sleep doctor from the Sleep Disorder Clinic at Mitra Kemayoran Hospital in Central Jakarta, said many people don’t take sleep disorders seriously enough. These include obstructive sleep apnea, an ailment characterized by excessive daytime sleepiness (or hypersomnia) and snoring.

“Most people believe you snore because you are exhausted during the day or did not have enough sleep the night before. It is not that simple,” he said.

Snoring is an early warning sign of a sleep disorder, he said, and people should pay particular attention to whether there are pauses, or apneas, in breathing while snoring. The pause is caused by a blockage of the airflow.

“This will cause interrupted sleep, also known as fragmented sleep,” Andreas said. “Most people who suffer from sleep apnea do not realize it because they are asleep, and each pause normally lasts for only a few seconds. They may be asleep for six or seven hours a night, but their sleep is actually interrupted.”

Andreas said sleep apnea carried both health and social risks. The disorder can lead to high blood pressure, heart problems, stroke, brain damage, diabetes, depression, obesity and death.

“Socially, it is disturbing and causes an uncomfortable situation for other people. I have had a lot patients come to me and say their partner was complaining about their snoring,” he said. “During the day, they feel sleepy and weak, have difficulty concentrating and become very emotional and sensitive, which can sour their relationship with other people.”

But Andreas said most doctors here were not aware that such symptoms could be caused by sleep apnea.

“They tend to diagnose something else. Meanwhile in developed countries, where people have a better knowledge and understanding of sleep disorders, the first question a doctor will ask the patient is whether they sleep well at night,” said Andreas, who is one of Indonesia’s two sleep specialists. “This is a serious matter. We can’t ignore this.”

He also pointed out that sleep apnea can affect anyone — young and old, male or female.

“One of my patients is 6 years old and has the fourth-worst case of sleep apnea in our clinic. The child had 106 pauses every hour when sleeping,” he said.

To determine whether you suffer from obstructive sleep apnea, Andreas recommended an overnight sleep study.

“In a sleep laboratory that has been set up to make you feel comfortable, your sleep is observed all night long,” he said. “Basically we monitor and record all physical activities while you are sleeping, including brainwave activity, breathing patterns, heart rate and eye movements.”

After obstructive sleep apnea is diagnosed, the sleep specialist can recommend the proper treatment, Andreas said.

The most recommended and effective treatment is using a Continuous Positive Airway Pressure device, a mask that helps patients breathe while they are asleep.

In some cases, surgery may be required to reconstruct the breathing channel anatomy, Andreas said.

“But I would suggest using the CPAP first for anyone whose sleep apnea is more than 15 times per hour. It works most of the time,” he said.

Given that a sleep disorder can be a silent killer, Andreas said it was important for friends and partners to inform people who snore to be alert, because most people who suffer from the condition are unaware they have a problem.

“You could save their life,” he said.

Tips for a better night’s sleep:
Although the amount of sleep required differs from person to person, it is recommended that people get seven to eight hours of sleep a night.
Avoid caffeine at least nine hours before going to bed.
Avoid working out three hours prior to going to bed.
Finish all your work at least an hour before you go to bed. Give your body and mind a break from work-related matters.

For more information and tips, follow @IDTidurSehat on Twitter.


15-minute nap can make difference, expert says

Prodita Sabarini ,  The Jakarta Post ,  Jakarta   |  Fri, 08/14/2009 2:10 PM  |  Headlines

Taking a 15-minute nap during the day can restore one’s energy and increase concentration, a sleep specialist says.

Sleep specialist Andreas Prasadja said Thursday that people in Indonesia were unaware of the importance of getting a good night’s sleep and how to make up for a lack of sleep, meaning many people feel tired unnecessarily.

Sleep deprivation can be caused by difficulties in falling asleep and insomnia to bad quality sleep due to sleep apnea, he said.

One of way to restore one’s energy is to take a short nap during the day, Andreas said. “One can take a nap at their desk or in their car. In Jakarta, people take at least an hour traveling anyway,” he said.

He said Indonesians still associate sleep or being sleepy as a sign of laziness. “Feeling sleepy during the day time or feeling tired can actually be the result of a sleep disorder.”

He added that sleep disorders can be dangerous. “Sleep apnea can be a silent killer,” he said.

Andreas was speaking at the launching of his book Ayo Bangun! (Wake Up!), about healthy sleeping habits, and the relaunch of Mitra Kemayoran’s Hospital Sleep Disorder Clinic.

The clinic, which opened in 2002, is the first of its kind in the country. Andreas is one of only two Indonesia’s sleep specialists.

“Most cities abroad have at least one sleep center, but in Indonesia the awareness among both the public and the medical community about sleep is still low,” he said.

He said a US study showed that one out of five Americans have a sleep disorder, but added that there has yet to be a similar study conducted among Indonesians. However, he said that the rate of sleep disorders was likely higher than that in the US.

He said that a common misconception in Indonesia is that people who snore sleep well. He said that if left untreated, snoring can cause hypertension, heart failure, diabetes or stroke.

Snoring is a type of sleep disorder clinically known as Obstructive Sleep Apnea (OSA).

“When people snore, their respiration tract gets clogged, due to the relaxing of muscles during sleep, and this makes them stop breathing. As a reflex the brain wake them up, often gasping for air. This means people who snore wake up continuously at night even though they might not be entirely conscious,” he said.


Seminar Snoring & Sleep Apnea

Seminar Kesehatan Tidur

Fakultas Kedokteran UKI – Cawang, 1 Agustus 2007




Dr. Andreas Prasadja, RPSGT, Sleep Technologist




Dr. Soekirman Sp.THT





Snoring no laughing matter: Specialists

Prodita Sabarini, The Jakarta Post, Jakarta | Mon, 03/02/2009 2:13 PM | Jakarta

Many Jakartans are unaware of the health and social risks that come with sleeping disorders, seeing insomnia as a regular part of urban life or assuming that snoring as a sign of deep sleep, a sleep specialist says.

Dr. Andreas Prasadja, a sleep physician at the Mitra Kemayoran Sleep Laboratory, pointed out a lack of sleep poses health risks and contributes to the number of traffic accidents in the city.

“We’ve heard about so many traffic accidents being caused by drivers falling asleep at the wheel,” he said Friday at a seminar on sleeping disorders.

Andreas said he hoped to dispel two commonly believed false notions: Sleep as a sign for laziness and snoring was a sign of deep, restful slumber.

He said our urban lifestyle, which hails productivity and runs by the motto “work hard, play hard”, has contributed to people’s sleep problems.

For productivity’s sake people force themselves to work long hours using stimulants which then keep users awake when it was time to rest. Light sleeping is not the only consequence: overuse of stimulants can lead to kidney failure.

He also said exercising just before going to bed can disrupt sleep as well as a brightly lit room, or snuggling up with our digital sidekicks, laptops and cell phones, before snoozing.

He said people should avoid taking stimulants – including caffeine, nicotine, and chocolate – nine hours before going to sleep, replacing them with relaxing drinks such as camomile tea.

He also encouraged people to finish their exercise regimes three hours before going to bed and to stop all work-related activities an hour before.

“When you feel really sleepy, then go to bed. Do not do anything in bed except sleep and have sex,” he said.

Another sleep disorder which is the most common and the most dangerous but also the most ignored is snoring.

“Snoring is not a laughing matter. It’s serious. If untreated it can cause hypertension, heart failure, diabetes or stroke,” he said.

He said that hypersomnia, a condition where people feel excessive daytime sleepiness despite long nighttime sleep might be caused by sleep apnea, a sleep disorder characterized by pauses in breathing during sleep, common among people who snore.

“During sleep the muscles of the body relax, including the soft tissue around the air way in the throat area. These tissues can collapse and obstruct breathing during sleep, causing people to stop breathing until they gasp for air,” he said.

To take in air, sufferers must wake over and over so they are never fully rested and can wind up with chronic, life-threatening consequences of extended sleep deprivation.

The importance of sleep, however, has yet to be fully understood by the public, including doctors, Andreas said.

“In Indonesia doctors diagnosing patients with hypertension or diabetes still rarely ask how well their patient is sleeping at night. In developed countries, that question is one the first questions the doctors ask a patient,” he said.

Lalaine Gedal, a Singapore-based sleep physician, said the prevalence of sleep apnea among 35-year-olds is 20 percent among men, and 5 percent among women. Among the elderly, 60 percent of men have sleep apnea and 40 percent of women.

A patient of Andreas said he had not realized he had been suffering from sleep apnea until he became very tired every day, dozing off during meetings and even while driving.

For those who dread surgical interventions, an effective and noninvasive method for stopping snoring involves a machine. Andreas’ patient now uses a Continuous Positive Airway Pressure device known as a CPAP.

The CPAP includes a mask with air tubes and a fan. It uses air pressure to push the user’s tongue forward and keep the throat open. This allows air to pass through the airway consistently. It reduces snoring and prevents apnea wake-ups.

There are only two sleep specialists in Indonesia, both based in Jakarta. Andreas and Rimawati Tedjasukmana founded Thursday the Indonesian Society of Sleep Medicine, or INA Sleep.

Andreas said he hoped to educate people about sleeping disorders, through the organization.