Snoring

Forty percent of adults and 8% of children snore. Snoring can affect sleep quality and daytime functioning. It can also interfere with a significant other’s life. Even if you aren’t aware of being a snorer, a bed partner or someone in another room may hear you while you’re asleep.  While snoring is often benign it may be one of the first signs of a more serious condition.

What is Snoring?

Basically, it is an unwanted sound that is created during sleep. The sounds can range from harsh, snorting, grunting or hoarse sounds to a wheezing or whistling. The duration, frequency and severity of snoring may also be variable. Some people may snore intermittently. Others may snore all night and every night. Some people may snore quietly. Others may snore so loudly that they can be heard down the hall.

What causes the sound?

When you play an instrument or when you talk, you create vibration that creates sound. When you play an instrument it is a string. When you talk it is your vocal cords. When snoring takes place, vibrations are caused by breathing during sleep. Vibrations from any part of your airway such as your tongue, lining of your throat or vocal cords can cause these undesirable sounds. While the same physics of vibration make the sounds we enjoy, snoring is never music to the ears.

During sleep snoring is usually caused by a narrowing, loosening or obstruction of upper airway structures. Often it is the uvula or soft palate. Other times it is from tense or loose muscle or fat around the throat, or a deviated or obstructed nasal passage. Snoring can be worsened by your weight, smoking, sleep position or an alcoholic beverage before bedtime.

Is Snoring a big deal?

Early studies conducted on snoring showed it could contribute to heart disease, high blood pressure and stroke. However, those studies did not differentiate between snoring and sleep apnea. Subsequent studies focusing on isolated snoring did not confirm earlier findings. However, an association has been found between increased carotid artery plaque formation and snoring. This could theoretically lead to worsening of existing disease leading to strokes. In addition, snoring has been shown to lead to marital dissatisfaction due to disrupted sleep.

While isolated snoring may be benign, snoring can progress to sleep apnea or be one of the warning signs of existing disease. Sleep apnea has been shown to have many adverse health consequences. [include which associations]. The severity of snoring and the presence of other symptoms have been shown to predict the likelihood of OSA.  Several questionnaires have also been developed to help health care practitioners screen individuals who should be evaluated for sleep apnea.

How can it be treated?

Sleep Medicine doctors can be helpful. They specialize in treating snoring and other sleep related disorders. They can help to ensure that you don’t have something more severe like sleep apnea. For isolated snoring several conservative approaches may be helpful such as:

• weight loss
• quit smoking
• avoid alcohol before bedtime
• changing your sleep position

These methods all aim to modify your upper airway allowing air to pass without causing any unwanted sounds. Weight loss in overweight individuals has been shown to be particularly helpful as it can reduce the amount of fat around the airway. Changing your sleep position from sleeping on your back to your side can take advantage of gravity to open up the side of your airway creating more room for air to travel. Smoking,  alcohol and some drugs such as benzodiazepines have both been to make healthy volunteers snore. Cutting down on these substances can increase airflow while you sleep, helping to eliminate snoring. Another option is to trial using an over the counter nasal strip such as breathe right. This can sometimes help dilate your nostrils to increase airflow through your nasal passageway. This can be especially useful to trial if nasal congestion plays a role in your snoring.

If lifestyle modifications aren’t enough,  a trip to a sleep medicine specialist might be a good idea. They can evaluate the cause of your snoring and help provide a customized treatment approach. Depending on your individual case, medications, oral appliances or even surgery might be reasonable options to help control your snoring.

Your physician could suggest one of the following to increase nasal patency:

• decongestants
• intranasal glucocorticoids
• provent
• surgery (for septal deviation)

Alternatively, several treatments often used for obstructive sleep apnea can also be used to successfully to treat snoring:

• continuous positive airway pressure (CPAP)
• oral appliance
• surgery to modify your upper airway

Alternative treatments

Some alternative treatments have been advanced to help with snoring. They include lubricants, nasal sprays and homeopathic remedies. These products have not yet been proven to work. For example, preliminary research has shown improvement in daytime sleepiness or snoring for individuals playing wind instruments such as the didgeridoo or singing for 20 to 25 minutes a day. Researchers theorize that exercising the muscles of the upper airway might help improve snoring. It still remains too early to evaluate whether such therapies will work. Before you take up the didgeridoo it might be easier to stick to some proven methods of ameliorating snoring such as good sleep, diet and exercise that leads to weight loss.