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Chronic Snoring

Medically Reviewed by Dr. Sahil Chopra

What is Chronic Snoring?

Snoring is loud breathing that occurs during sleep. It can happen during inhalation or exhalation, however snoring with inhalation is most common. It can sound like unpleasant rattling, vibrating, or sawing. Chronic snoring is snoring that happens most nights, even when you’re not sick or suffering from allergy symptoms.

Is snoring bad for your health? Chronic untreated snoring gives clues about the increased resistance of the upper airway that may be resulting in impaired breathing during sleep. If breathing is impared during sleep, snoring can pose serious health threats. Chronic snoring is associated with an increased incidence of neurodegenerative diseases, diabetes, metabolic syndrome, heart disease, and stroke.

Regular snoring can lead to poor sleep, daytime fatigue, lowers daytime performance, and increases the risk of drowsy driving. Chronic snorers who do not have sleep apnea still have twice the incidence of excessive daytime sleepiness.

People who snore often aren’t aware of the condition. These symptoms are clues that you may be snoring at night:

  • Waking with a headache
  • Dry mouth in the morning
  • Dental decay or cavities
  • Daytime fatigue
  • Sudden nighttime awakenings
  • Wheezing, gasping or coughing during the night

What Causes Snoring?

Snoring occurs as the result of a narrowing of the upper airway or when nasal breathing is obstructed. Muscles that keep the airway open while one is awake relax during sleep, reducing the diameter of the upper airway. Air flow against a narrow upper airway results in turbulence and vibration of the soft tissue thus making the sound of snoring. Anything that narrows or relaxes the soft tissues in the mouth and throat can lead to snoring. If the upper airway becomes narrow enough during sleep it can collapse, resulting in a complete cessation of breathing. This causes an apnea, the most worrisome consequence of snoring. This is why snoring is more common after drinking alcohol or taking certain sedating medications.

These factors increase the risk of snoring:

  • Obesity
  • Pregnancy
  • Age
  • Nasal congestion from illness or allergies
  • Swollen adenoids or tonsils
  • Large soft palate or uvula
  • Nasal deformity like a deviated septum
  • Side effects of some medications
  • Drinking alcohol, especially before bed
  • Sleeping on your back

Snoring or Sleep Apnea?

Snoring is not the same as sleep apnea, although the terms are sometimes confused.

Obstructive sleep apnea and central sleep apnea are conditions involving temporary breathing interruptions during sleep. These breathing pauses can result in a transient drop in blood oxygen levels and allow carbon dioxide to build up in the body. The drop in oxygen levels results in a stress response that wakes up the brain and body during sleep to restart normal breathing. Patients with sleep apnea cycle through sleep and arousals many times per hour resulting in poor sleep quality, excessive daytime sleepiness, and non-refreshing sleep.

By contrast, isolated habitual snoring does not involve apneas, or breathing interruptions, during sleep.

However, chronic snoring is a warning sign for sleep apnea. Between 50 to 75 percent of people who snore also have obstructive sleep apnea.

  • If you snore and notice any of the warning signs of sleep apnea, seek treatment from a doctor
    • Your snoring is accompanied by pauses, gasps, or snorts that stop your breathing or awaken you at night
    • You experience excessive daytime sleepiness, headaches and mood or memory problems
    • You have unexplained weight gain

How Common is Snoring?

Around 45% of adult men and 30% of women snore regularly. Anyone can snore, but certain physical attributes make snoring more likely. Snoring is more common in men than women, and carrying excess body weight increases the risk of snoring. The likelihood of snoring increases with age.

As pregnancy progresses, one in three women snore during pregnancy, due to increased body weight, hormone fluctuations, increased pressure on the diaphragm and swelling of the nasal passages.

Around 10 percent of young children snore every night. Babies and newborns snore due to small nasal passages, though this is usually outgrown. As with childhood sleep apnea, chronic snoring in childhood is associated with negative cognitive effects and poor school performance.

Certain disabilities affecting facial features or the architecture of the nose, throat, or nasal passages can make snoring more likely. For example, individuals with Down syndrome tend to have a smaller jaw, a narrower throat, smaller nasal passages, and larger tongues and tonsils, which make snoring more likely.

Sleeping on your back can cause the tongue to relax into the upper airway, increasing snoring risk. Snorers often experience relief by switching to side sleeping.

Managing Snoring

Snoring can be managed in a variety of different ways. Therapy should be personalized by your doctor.  Snoring is the result of an obstruction of the upper airway, so using interventions to target this narrowing is important. Management strategies include  behavioral interventions, prescription interventions, and surgery.

Snoring damages your health and annoys your bedmate. Fortunately, treatments exist for chronic snoring. Many are simple, natural fixes to try at home. The biggest challenge may be convincing the person who snores that he or she needs intervention.

Behavioral Therapies for Snoring

Natural, low-cost treatment for snoring begins with behavioral interventions. Some snorers can alleviate or completely get rid of symptoms with a few lifestyle changes, such as:

  • Weight loss (even a minor loss can reduce snoring), however this can take time.
  • 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

Anti-snoring Products

If behavioral changes don’t relieve snoring symptoms, snorers can invest in various anti-snoring products.

Anti-snoring pillows
While using regular 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 to maintain open airways. Special body pillows can help snorers maintain a side-sleeping position.

Anti-snoring sleepwear
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
Other 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. Nasal strips may offer a low-cost, drug-free way to stop snoring while pregnant.

Nasal decongestants
If nasal congestion causes inflammation and swelling that hinders normal airflow, over-the-counter decongestants can help.

Nose vents
Nose vents are nasal dilators that maximize airflow through the nasal passages. These are typically made of silicone and sold in various sizes, similar to earbuds.

Air purifiers
If 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.

Other medications
Research has shown that 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.

CPAP therapy
CPAP (continuous positive airway pressure) therapy can treat snoring that accompanies sleep apnea. 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
Oral 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.

For some patients, oral appliances are more effective than CPAP machines. CPAP machines suffer from notoriously low usage rates because of discomfort. Anti-snoring mouthpieces are smaller, more discreet, more portable and easier to use. Oral devices are also often an effective treatment for teeth grinding (bruxism) during sleep.

Surgery for Snoring

If behavioral therapies or products do not correct snoring, surgical options may help. Surgical treatment depends on the site from which snoring is originating. Consult your doctor for more information.

Normally, the septum is a small piece of cartilage separating the nostrils. When the septum is pushed to one side or the other, often due to injury, snoring can occur. A septoplasty is a surgery that realigns the septum to improve nasal airflow.

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.

Somnoplasty, along with another surgical technique called coblation-channeling, shrink throat tissues with heat, allowing easier breathing. 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 these techniques.

A tonsillectomy is a common surgical procedure that removes the tonsils. Located at the back of your throat, tonsils can obstruct breathing if they become 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.

Experimental therapies involving radio wave treatments that shrink soft tissues blocking the airway have also shown promise.

Tips for Sleeping with a Snorer

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

So don’t get mad—get back to sleep instead!

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 mattress also make it easier for you to fall asleep.

Try staggering your bedtimes slightly so that the non-snorer goes to sleep before the snorer. If you are already asleep before your partner begins snoring, you may be less likely to wake up.

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.

Additional Resources:

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