Drink? by Professor David Nutt

Author:Professor David Nutt [NUTT, DAVID]
Language: eng
Format: epub
Publisher: Hachette Books
Published: 2020-12-22T00:00:00+00:00

Do you snore? If so, you’ve probably been told that you’re much noisier after a drink. Snoring is a sign of the beginning of an obstruction in the air going in and out of your lungs. Drinking makes it worse because alcohol relaxes your muscles, including those of your pharynx and palate, the soft tissues at the back of your mouth and in your throat.

Snoring can develop into sleep apnea: this is where your airways collapse so you can’t get any air into or out of your lungs. It deprives your brain of oxygen, a condition called hypoxia, just as if you had a plastic bag over your head.

A hypoxic episode can last 20 or 30 seconds until your brain gets so stressed that it fires off a massive fight-or-flight response. You then take an abrupt breath and your airways open for a few minutes, until you go back into a deeper level of sleep. Usually the stress response doesn’t wake up the person having it, but the snoring and spluttering that accompany it can be very irritating—and possibly worrying—to any bed partner, who may feel that the apneic person is never going to start breathing again. In my sleep clinic I would come across nondrinking partners staying awake for hours “just in case” they had to revive their partner.

For many people, this pattern of hypoxia followed by a mini stress response repeats itself, sometimes hundreds of times a night. Over days and weeks, each episode adds up, which can lead to daytime sleepiness but also problems such as hypertension and obesity.

Treatment involves keeping the airways open with a Continuous Positive Airway Pressure machine (CPAP). The downside of these machines is their noise; they tend to keep the person’s poor partner awake and may be even worse than the snoring.

Both snoring and sleep apnea are more likely if you’re overweight. There’s a vicious circle I used to see quite often in my sleep clinic: fat men who snore and drink and keep getting fatter. Poor sleep increases ghrelin, the hormone from the stomach that increases your appetite for food and for alcohol too. It also reduces the level of the satiety hormone leptin. (Spikes in ghrelin may be partly responsible for the fact that you feel so hungry the day after drinking too.2)

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