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Snoring, a common occurrence where air flows past relaxed throat tissues causing them to vibrate, can be normal for people of all ages, including babies and young children. However, loud and frequent snoring may be a sign of sleep apnea, a serious condition where breathing stops temporarily during sleep. If snoring is accompanied by symptoms such as gasping for air, fatigue, or irritability, it’s important to consult a healthcare provider.
To manage snoring, lifestyle changes such as losing weight, avoiding alcohol close to bedtime, and sleeping on your side can be effective. Additionally, medical devices and surgical options are available to reduce disruptive snoring, although they may not be necessary for everyone.
Symptoms
Snoring can sometimes be a sign of a more serious condition known as obstructive sleep apnea (OSA). While not all snorers have OSA, certain symptoms paired with snoring may warrant a visit to your doctor for an evaluation:
- Breathing issues: Witnessed pauses in breathing during sleep, gasping, or choking at night.
- Sleep disruptions: Excessive daytime sleepiness, restless sleep, or waking up frequently with a loud snort or gasping sound.
- Physical symptoms: Morning headaches, sore throat upon waking, high blood pressure, or nighttime chest pain.
- Mental and emotional symptoms: Difficulty concentrating, poor attention span in children, behavioral issues, or poor academic performance in school.
- Volume of snoring: Extremely loud snoring that disrupts a partner’s sleep.
OSA is typically characterized by loud snoring followed by a silent period when breathing stops or nearly stops. Such pauses can occur multiple times per hour of sleep, disrupting sleep quality and leading to light sleep.
Consult your doctor if you experience any of the symptoms listed, as they may suggest the presence of OSA. It’s particularly important to speak to a pediatrician if your child snores, as children can also develop OSA due to factors like enlarged tonsils or obesity, which can narrow their airway.
Causes
Several factors can lead to snoring by causing blockages in the airway:
- Age: As muscle tone decreases with age, airways tend to constrict, making snoring more common in older adults.
- Alcohol and sedatives: These substances relax the muscles in the throat, which can restrict airflow and lead to snoring.
- Anatomical factors: Features like enlarged adenoids, large tonsils, or a big tongue can obstruct airflow. A deviated septum, where the cartilage separating the nostrils is off-center, can also impede air movement.
- Biological sex: Snoring is more frequently reported in people assigned male at birth.
- Family history: Genetics play a role; having a parent who snores increases the likelihood of snoring.
- Overall health: Conditions that cause nasal congestion, such as allergies or the common cold, can block airflow. Hormonal changes in pregnancy can also lead to snoring.
- Weight: Higher body mass index (BMI) is linked to snoring and sleep-related breathing disorders, with increased risks in individuals who are overweight or obese.
- Sleep deprivation: Insufficient sleep can lead to excessive relaxation of throat muscles when you do sleep, worsening snoring.
- Sleep position: Sleeping on the back often exacerbates snoring because gravity affects the throat in a way that narrows the airway.
Mechanism behind snoring:
- Airway obstruction: During the transition from light to deep sleep, the muscles in the soft palate, tongue, and throat relax. If they relax significantly, they can partially block the airway and vibrate as air moves through, creating the snoring sound.
- Vibration points: The soft palate, tonsils, adenoids, and tongue are common sites where these vibrations occur.
Impact of narrowed airway: The narrower the airway, the more forceful the airflow becomes. This increased force intensifies tissue vibration, which amplifies the snoring sound.
Risk factors
Several factors can increase the likelihood of snoring, including:
- Airway structure: Narrow airways due to a long soft palate, or enlarged tonsils or adenoids can lead to snoring.
- Nasal issues: Structural defects like a deviated septum or chronic nasal congestion can increase snoring risk.
- Gender: Men are more prone to snoring and sleep apnea than women.
- Weight: Overweight and obese individuals are at higher risk of snoring and obstructive sleep apnea.
- Alcohol consumption: Drinking alcohol relaxes the throat muscles, which can exacerbate snoring.
- Family history: Genetics can play a role, as those with a family history of snoring or obstructive sleep apnea may be more susceptible.
Diagnosis
The following procedure will assist the healthcare provider to properly diagnose snoring:
- Physical examination: A healthcare provider will conduct a physical examination of your mouth, throat, and nose and review your medical history along with your symptoms. To assess the severity of the issue, your healthcare provider may also inquire about your snoring patterns and frequency from your partner. If your child is the one snoring, you will be asked about the loudness of their snores.
- Imaging test: An imaging test, like an X-ray, computed tomography (CT) scan, or magnetic resonance imaging, may be prescribed by your healthcare provider. These examinations look for structural issues with your airway, such a deviated septum.
- Sleep study: Your healthcare provider might want to perform a polysomnography or sleep study, depending on how severe your snoring is and other symptoms. It’s possible to do sleep study at home on occasion.
However, you might have to spend the night at a sleep center in order to have a thorough examination of your breathing during a sleep study, depending on your other medical conditions and other sleep-related symptoms.
During a polysomnography, you are monitored all night long while attached to numerous sensors. The following details, including your blood oxygen level, respiration, heart rate, brain waves, sleep stages, and eye and leg movements, will be recorded during the sleep study.
Treatment
Several approaches are used by healthcare providers to lessen snoring. The best choice for you will rely on a number of variables, such as how severe your snoring is, your medical history, and your personal preferences.
Improved sleeping posture and opening airways are the main goals of nonsurgical treatments for snoring. These medical interventions could consist of:
- Lifestyle modification: You can lessen snoring by shifting your sleeping position, refraining from alcoholic beverages, and maintaining a healthy weight.
- Medication: Medication for allergies and colds clears your nasal congestion so you can breathe easily.
- Nasal strips: Maintaining open nasal passages can be facilitated by wearing nasal strips, which are flexible bands that adhere to the exterior of the nose.
- Oral appliances: Dental mouthpieces that fit firmly that advance your jaw, tongue, and soft palate to maintain an open airway are called oral appliances.
If you decide to utilize an oral appliance, you will fit and position it as best you can with the help of your dentist. In order to ensure that the oral appliance is performing as intended, you will also collaborate with your sleep specialist. For the purpose of checking your fit and evaluating your dental health, you may need to see a dentist at least once every six months for the first year and then once a year after that.
Wearing these devices may cause negative effects such as dry mouth, excessive salivation, jaw pain, and facial discomfort.
- Continuous positive airway pressure (CPAP): This method involves covering your mouth or nose while you sleep with a mask. To keep your airway open while you sleep, the mask uses pressurized air directed by a small bedside pump.
The most common use of CPAP is to treat snoring that is linked to OSA since it stops the snore altogether. While CPAP is the most dependable and successful way to treat OSA, some people find it uncomfortable or find it difficult to get used to the machine’s loudness or feel.
Your healthcare providers may perform surgery to address severe snoring. Reducing or removing extra tissue or fixing a structural problem (such as a deviated septum) are the two main objectives of surgery. Surgical interventions could involve:
- Uvulopalatopharyngoplasty (UPPP): The procedure enhances airflow and decreases tissue in your soft palate. After administering general anesthesia, your surgeon performs a throat lift by tightening and trimming extra tissue.
- Maxillomandibular advancement (MMA): The upper and lower jaws are moved forward during aprocedure known as maxillomandibular advancement (MMA) that helps in opening the airway.
- Radiofrequency tissue ablation: A low-intensity radiofrequency signal is used in radiofrequency tissue ablation to reduce tissue in the tongue, soft palate, and nose. This procedure is also known as somnoplasty.
- Hypoglossal nerve stimulation: A more recent surgical method known as hypoglossal nerve stimulation applies a stimulus to the nerve that controls the tongue’s forward motion so the tongue won’t obstruct the airway when you inhale.
- Septoplasty: Your healthcare provider may advise septoplasty if your septum is deviated. A septoplasty reshapes the bone and cartilage in your nose to optimize ventilation.
- Tonsillectomy or adenoidectomy: An excess of tissue is removed by a surgeon from the back of the nose (adenoidectomy) or the back of the throat (tonsillectomy).
