THE SNORING CURE

THE SNORING CURE: SIMPLE STEPS TO GETTING A GOOD NIGHT'S SLEEP
Laurence A. Smolley and Debra Fulghum Bruce
New York: W.W. Norton & Company, 1999
160 pages, hardcover, $23.95
ISBN: 0-393047423

Reviewed by Lynne Lamberg

People who snore typically don't believe they make as much noise as others tell them. Those who live with snorers can't believe the noise is that bad. The sounds of snoring are, of course, a sign that's something wrong with breathing during sleep.

This clearly and conversationally written book reviews causes and health implications of snoring. Lung specialist Laurence A. Smolley and medical writer Debra Fulghum Bruce say some 45 percent of normal adults snore occasionally. Though often thought of as a "male" problem, snoring grows more common in women with age, particularly after menopause brings changes in hormones and fat distribution. By age 60, 40 percent of women and 60 percent of men habitually snore. There's some evidence that people who snore have a smaller upper airway than those who don't.

Ten to 50 percent of the habitual snorers--the raucously loud ones--have obstructive sleep apnea, a disorder in which the airway narrows even further in sleep. Sleepers gasp as they awaken repeatedly to get some air, dozens, even hundreds of times a night. These awakenings usually are too brief to remember in the morning. Hence, these people do not complain of a bad night but rather of profound daytime sleepiness.

The authors tell readers with a snoring problem how to get an accurate diagnosis. They review the benefits of weight loss, and describe both medical and surgical remedies. Nasal continuous positive airway pressure, or use of device to keep airways open in sleep, they say, is the "treatment of choice" for most persons with obstructive sleep apnea.

Early in the book, the authors optimistically describe weight loss as "an easy cure." Later on, they acknowledge that changing a lifetime of poor eating habits is not a piece of cake. Indeed, statistics on weight loss are discouraging. A review of obesity research in the June 2000 American Journal of Psychiatry reported that most people who lose weight regain half the pounds they lost within a year, and most put back on most or all their lost weight within five years. The authors work hard to persuade readers of the benefits of eating less and exercising more. They recommend a diet low in fat, such as that outlined by Dean Ornish, or a vegetarian diet. They also suggest counting calories and eating frequent but small meals to avoid feeling depressed and deprived. They further advise scheduling short bursts of exercise through the day.

Throughout the book, Smolley and Bruce provide symptom checklists, self-tests, line drawings of nose and throat anatomy, comparisons of different types of treatment, and other useful charts and graphs. The book also includes a glossary and a list of organizations providing more information on sleep and sleep apnea. While it lacks a bibliography, the authors' expertise gives their assertions high credibility. This is a substantive, practical guide for people who snore, members of their families, and persons diagnosed with sleep apnea.