Forty-five percent of normal adults snore at least occasionally, and 25
percent are habitual snorers. Problem snoring is more frequent in males and
overweight persons, and it usually grows worse with age.
More than 300 devices are registered in the U.S. Patent and Trademark
Office as cures for snoring. Some are variations on the old idea of sewing a
sock that holds a tennis ball on the pajama back to force the snorer to
sleep on his side. (Snoring is often worse when a person sleeps on his
back). Some devices reposition the lower jaw forward; some open nasal air
passages; a few others have been designed to condition a person not to snore
by producing unpleasant stimuli when snoring occurs. But, if you snore, the
truth is that it is not under your control whatsoever. If anti-snoring
devices work, it is probably because they keep you awake.
What Causes Snoring?
The noisy sounds of snoring occur when there is an obstruction to the
free flow of air through the passages at the back of the mouth and nose.
This area is the collapsible part of the airway (see illustration) where the
tongue and upper throat meet the soft palate and uvula. Snoring occurs when
these structures strike each other and vibrate during breathing.
People who snore may suffer from:
- Poor muscle tone in the tongue and throat. When muscles are too
relaxed, either from alcohol or drugs that cause sleepiness, the tongue
falls backwards into the airway or the throat muscles draw in from the
sides into the airway. This can also happen during deep sleep.
- Excessive bulkiness of throat tissue. Children with large tonsils
and adenoids often snore. Overweight people have bulky neck tissue, too.
Cysts or tumors can also cause bulk, but they are rare.
- Long soft palate and/or uvula. A long palate narrows the opening
from the nose into the throat. As it dangles, it acts as a noisy flutter
valve during relaxed breathing. A long uvula makes matters even worse.
- Obstructed nasal airways. A stuffy or blocked nose requires extra
effort to pull air through it. This creates an exaggerated vacuum in the
throat, and pulls together the floppy tissues of the throat, and snoring
results. So, snoring often occurs only during the hay fever season or
with a cold or sinus infection.
Also, deformities of the nose or nasal septum, such as a deviated septum
(a deformity of the wall that separates one nostril from the other) can
cause such an obstruction.
Is Snoring Serious?
Socially, yes! It can be, when it makes the snorer an object of ridicule
and causes others sleepless nights and resentfulness.
Medically, yes! It disturbs sleeping patterns and deprives the snorer of
appropriate rest. When snoring is severe, it can cause serious, long-term
health problems, including obstructive sleep apnea.
Obstructive Sleep Apnea
When loud snoring is interrupted by frequent episodes of totally
obstructed breathing, it is known as obstructive sleep apnea. Serious
episodes last more than ten seconds each and occur more than seven times per
hour. Apnea patients may experience 30 to 300 such events per night. These
episodes can reduce blood oxygen levels, causing the heart to pump harder.
The immediate effect of sleep apnea is that the snorer must sleep lightly
and keep his muscles tense in order to keep airflow to the lungs. Because
the snorer does not get a good rest, he may be sleepy during the day, which
impairs job performance and makes him a hazardous driver or equipment
operator. After many years with this disorder, elevated blood pressure and
heart enlargement may occur.
Can Heavy Snoring be Cured?
Heavy snorers, those who snore in any position or are disruptive to the
family, should seek medical advice to ensure that sleep apnea is not a
problem. An otolaryngologist will provide a thorough examination of the
nose, mouth, throat, palate, and neck. A sleep study in a laboratory
environment may be necessary to determine how serious the snoring is and
what effects it has on the snorer's health.
Snoring Treatment
Treatment depends on the diagnosis. An examination will reveal if the
snoring is caused by nasal allergy, infection, deformity, or tonsils and
adenoids.
Snoring or obstructive sleep apnea may respond to various treatments now
offered by many otolaryngologist-head and neck surgeons:
- Uvulopalatopharyngoplasty (UPPP) is surgery for
treating obstructive sleep apnea. It tightens flabby tissues in the
throat and palate, and expands air passages.
- Thermal Ablation Palatoplasty (TAP) refers to
procedures and techniques that treat snoring and some of them also are
used to treat various severities of obstructive sleep apnea. Different
types of TAP include bipolar cautery, laser, and radiofrequency. Laser
Assisted Uvula Palatoplasty (LAUP) treats snoring and mild obstructive
sleep apnea by removing the obstruction in the airway. A laser is used
to vaporize the uvula and a specified portion of the palate in a series
of small procedures in a doctor's office under local anesthesia.
Radiofrequency ablation—some with temperature control approved by the
FDA—utilizes a needle electrode to emit energy to shrink excess tissue
to the upper airway including the palate and uvula (for snoring), base
of the tongue (for obstructive sleep apnea), and nasal turbinates (for
chronic nasal obstruction).
- Genioglossus and hyod advancement is a surgical
procedure for the treatment of sleep apnea. It prevents collapse of the
lower throat and pulls the tongue muscles forward, thereby opening the
obstructed airway.
If surgery is too risky or unwanted, the patient may sleep every night
with a nasal mask that delivers air pressure into the throat; this is called
continuous positive airway pressure or CPAP.
A chronically snoring child should be examined for problems with his or
her tonsils and adenoids. A tonsillectomy and adenoidectomy may be required
to return the child to full health.
Self-Help for the Light Snorer
Adults who suffer from mild or occasional snoring should try the
following self-help remedies:
- Adopt a healthy and athletic lifestyle to develop good muscle tone
and lose weight.
- Avoid tranquilizers, sleeping pills, and antihistamines before
bedtime.
- Avoid alcohol for at least four hours and heavy meals or snacks for
three hours before retiring.
- Establish regular sleeping patterns
- Sleep on your side rather than your back.
- Tilt the head of your bed upwards four inches.
Remember, snoring means obstructed breathing, and obstruction can be
serious. It's not funny, and not hopeless.