Chronic Snoring

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Don’t let snoring impact your health, relationships, or performance. Discover the risk factors for snoring and what you can do to stop snoring or alleviate symptoms.

What is snoring?

Snoring is noisy breathing during sleep that sounds like a rattling, vibrating, or otherwise noisy sound.

What causes snoring?

Snoring occurs as the result of a narrowing of the upper airway. The soft tissue and muscles of the sleeper’s throat relax, and the diameter of the airway is reduced. This reduction can result in snoring just like air flowing through a whistle.

There are three main ways the upper airway can be obstructed:

  1. The most common site of obstruction is where the back of the tongue comes into contact with the throat.
  2. Snoring may also occur due to a narrowing of the nasal airways. If the nasal passages are compromised, the lungs must inhale with greater force to achieve the same amount of airflow into the body. This increased force can result in collapse of the upper throat area as well as snoring.
  3. A large soft palate or uvula contributes to the probability of snoring, which is part of the reason overweight people snore more.

Even if you don’t normally snore due to one of the physical factors described above, drinking alcohol (or consuming another sedative) can contribute to snoring. It makes your muscles relax, including your mouth and throat muscles. That’s why some people snore more when they are drunk, and loud snoring is a hallmark of someone who has passed out drunk.

How common is snoring?

The stereotypical snorer is an adult male, perhaps over 30 and overweight. However, anyone can snore, regardless of their body type. Some factors that make a person more likely to snore include:

  • Being overweight
  • Being pregnant
  • Being older
  • Nasal congestion from illness or allergies
  • Having swollen adenoids or tonsils
  • Having a large soft palate or uvula
  • Having a nasal deformity like a deviated septum
  • Side effects of some medications
  • Drinking alcohol, especially larger amounts before bed
  • Sleeping on your back

People of all ages, sexes, and body mass indices snore, although it is more common in men than women and more common in heavier people. It is estimated that 45% of adult men and 30% of women in the US suffer from chronic snoring; some of those have sleep apnea. The likelihood of snoring increases with age, since your throat muscles tend to relax more.

One in three pregnant women start snoring with the increased weight and body changes during pregnancy, such as a growing baby pressing on their diaphragm, and increased hormone production that causes the nasal passages to swell. These effects are worsened if the woman is already overweight prior to becoming pregnant.  

Around 10 percent of young children snore every night.  As with childhood apnea, snoring is associated with negative cognitive effects and poor school performance.

Certain physical makeups, such as obesity, certain disabilities, and the construction of the nose, throat, or nasal passages, make a person more likely to snore. For example, individuals with Down syndrome tend to have a smaller jaw, a narrower throat and nasal passages, and larger tongues and tonsils – these combine to facilitate snoring or sleep apnea. If an individual is unable to exercise due to their disability, they may also gain weight, which is another risk factor for snoring.

Sleeping on your back causes your tongue to fall back into your throat area, which makes you more likely to snore. The healthiest position to sleep in is on your side – it’s better for both your back and your airways.

Is snoring bad for your health?

Snoring can be an irritation to the snorer and to others in the house who have to hear him or her. It can also be a potentially serious problem requiring medical attention.

  • Chronic snoring is associated with an increased incidence of heart and brain-related diseases.
  • Snoring is also associated with greater rates of diabetes, heart disease, and stroke.
  • Chronic snorers who do not have apnea nevertheless have twice the incidence of excessive daytime sleepiness.
  • More snoring means more daytime fatigue, lower daytime performance, and greater likelihood for drowsy driving.
  • Daytime fatigue from snoring can impact school or work performance.
  • Loud snoring was found to be a risk factor for metabolic syndrome.

Snoring vs sleep apnea

Snoring is not the same as apnea, although they can be confused for each other.

Sleep apnea represents a spectrum of conditions in which the same airway obstruction that cause snoring worsens to the point that arousals occur and sleep for the patient is disrupted.

Estimates vary, but between 50 to 75 percent of people who snore also have obstructive sleep apnea. Sleep apnea is a much more serious sleep disorder that literally stops the person from breathing, if only for a few seconds. The more severe the apnea, the higher the individual’s risk of death.

While all individuals with sleep apnea also snore, the reverse is not the same. If you snore and notice any of the warning signs of sleep apnea, you should seek treatment from a doctor.

  • Your snoring is accompanied by pauses, gasps, or snorts that stop your breathing and/or rouse you  from sleep during the night
  • Your snoring is so disruptive that you experience excessive daytime sleepiness, headaches, or an overall lack of restfulness after sleep
  • You have recently gained weight

How to stop snoring

Not only does snoring have the potential for developing into more serious sleep conditions for the snorer, but it detrimentally affects others’ sleep environment. Fortunately, chronic snoring can be treated.  The biggest challenge may be convincing the person who snores that he or she needs intervention.

There is a range of treatments available for snoring, from behavior modification to devices and even surgery.

Anti-snoring behaviors

Some snorers can alleviate or completely get rid of symptoms with a few lifestyle changes, such as:

  • Losing weight (even a minor loss can reduce snoring)
  • Sleeping on the side instead of the back
  • Avoiding alcohol in the few hours before bedtime
  • Avoiding sedatives, antihistamines, and stimulants before bed
  • Exercising to improve muscle tone in the neck

If behavioral changes don’t reduce symptoms to a satisfactory degree, snorers can invest in various anti-snoring products.

Anti-snoring products

Anti-snoring pillows

anti snoring pillowWhile using pillows to tilt the body off its back is an option, specialized anti-snoring wedge pillows can accomplish this more effectively. These pillows align the jaw, neck, and throat in order to keep the airways open.

There are also body pillows that help the sleeper stay in a side sleeping positions.

Anti-snoring sleepwear

anti snoring sleep beltIf a pillow isn’t effective, special sleepwear and clothing accessories are available to promote sleeping on the side. For instance, some nightshirts have a tennis ball sewn in the area that fits between the shoulder blades so that the discomfort stimulates you to move onto your side even while sleeping. Alternately, inflatable belts can mimic the effect of a tennis ball.

Nasal strips

breathe right nasal stripsOther anti-snoring therapies focus on the nasal passages and airways. Nasal strips that are placed externally on the nose bridge flatten the nose and enhance nasal airflow by increasing the opening of the nostrils and adjacent nasal passages. According to research, the Breathe Right brand has proven to be effective.

Nasal decongestants

nasal decongestantsDecongestants can work if nasal congestion is causing inflammation and swelling that hinders normal airflow through the nose, such as when a person is sick or suffering from allergies. Many of these are available over the counter in tablet or spray form.

Some clinicians has found a combination of pseudoephedrine and domperidone can help snoring and apnea. Pseudoephedrine is a common cold medicine that reduces nasal congestion and domperidone suppresses nausea and vomiting.

Nose vents

nasal ventsNose vents are nasal dilators the snorer places in their nose to maximize airflow. These are typically made of silicone and packs usually come with varying sizes, similar to earbuds with headphones.

Air purifiers

air purifierIf the snorer also has allergies, air purifiers with a HEPA (high-efficiency particulate air) filter can reduce the allergens, dust mites, and other particles in your house that may be causing nasal congestion.

CPAP machines

cpap machineCPAP (continuous positive airway pressure) machines are usually used when sleep apnea syndromes are also present with snoring. CPAP machines generate air pressure through a mask on the nose and mouth to form an air splint in the throat while the user sleeps. The pressure keeps the airway from collapsing and prevents snoring. Various masks are available that can help individualize this treatment.

Anti-snoring mouthpieces

snoring mouthpieceOral appliances are specially formed and fitted dental mouth pieces that can pull the tongue forward, advance the lower jaw, or both. The airway in the throat area opens wider, reducing or preventing snoring. While some appliances are available without medical guidance, many dentists tailor them for patients.

Oral appliances are often more effective than CPAP machines. CPAP machines suffer from notoriously low usage rates because they are so uncomfortable. An anti-snoring mouthpiece is much more comfortable, so a client is more likely to wear it and effectively reduce symptoms.

Oral devices are also often an effective treatment for teeth grinding during sleep.

All images from Amazon.

Anti-snoring surgery

Lastly, there are surgical options geared at correcting the anatomy that is causing the snoring itself. Otolaryngologists – ear, nose, and throat doctors – are the specialists who often get involved. In addition to nasal surgery, techniques that target the throat or pharynx are employed.

Septoplasty

In addition, surgical treatment can address nasal conditions such as a deviated septum that likewise may be limiting airflow. Any of these can result in “mouth-breathing” at night, and as the jaw opens, the mechanics of the throat and jaw can further compromise the airway diameter. A septoplasty is a surgery that realigns the septum to improve nasal airflow.

Uvulopalatopharyngoplasty

An uvulopalatopharyngoplasty (UPPP or UP3) removes the uvula hanging from the roof of the soft palate along with some of the soft palatal tissue to expand the opening of the throat. Similar surgeries that are easier to perform also now include Laser Assisted Uvulopalatoplasty (LAUP). Uvuloplasty is surgery that removes the uvula to open the airway behind the palate. This is usually outpatient surgery and does not require a hospital stay. There have also been trials with radio wave treatment to shrink the tissue blocking the airway.

Somnoplasty

Somnoplasty, along with another surgical technique called coblation-channeling, uses heat to damage and shrink throat tissues, allowing expansion of the airway. Several treatments are needed. Another option is the injection of sclerosing agents into the soft palate. These agents cause the tissues of the pharynx to scar, and as the scar evolves, the tissues also shrink. While all of these measures can reduce snoring, relapse occurrence of snoring years later is relatively high with all of these techniques.

Tonsillectomy

A tonsillectomy is a common surgical procedure that removes the tonsils. Located at the back of your throat, tonsils can get in the way of air passages if they are enlarged. Having enlarged adenoids can be normal or a result of a condition like Down syndrome. One of the main reasons children get a tonsillectomy is to reduce snoring or sleep apnea symptoms.

Tips for sleeping with a snorer

Sometimes snoring poses more of a problem for the sleeping partner rather than the snorer themselves, especially if the snoring is keeping their partner up at night.

If you sleep with a loud snorer, encourage them to invest in some of the products above (or to see a sleep specialist if you’re worried it might be sleep apnea). However, be aware that even with treatment, it’s possible your partner’s snoring won’t go away entirely.

Fortunately, there are some things you can do to get a better night’s sleep, regardless of their snoring.

  • Invest in a white noise machine or smartphone app. White noise machines provide a static background of white noise, which is very effective at drowning out other noise. White noise smartphone apps are gaining in popularity because they don’t take up any extra space, and often include other types of sound libraries such as nature sounds and ambient music.
  • Use earplugs. Earplugs help reduce noise and come in varying sizes so you can find a good fit for your ears.
  • Get a larger mattress. Sleeping in separate beds or bedrooms will negatively impact both your intimacy and your wallets. Instead, investing in a larger mattress can be a cheaper alternative that still allows you to maintain your physical closeness as a couple.  Plus, having a comfortable will also make it easier for you to fall asleep.
  • Try meditation and relaxation exercises. Insomniacs often rely on meditation, relaxation exercises, and breathing techniques to help them fall asleep at night. These may help you fall asleep despite your partner’s snoring, or help you stay calm and go back to sleep if their snoring wakes you up. Getting frustrated will only energize you and make it even more difficult to fall back asleep.
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