• Snoring

    Definition

    Snoring is a sound made during sleep. It is the sound of the throat vibrating as air flows through.
    Blocked Airway
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Air should be able to easily move through your mouth, nose, and throat. Sometimes, during sleep, air cannot move through these areas easily. This turbulent airflow makes the roof of the mouth vibrate. This is what causes the snoring sound. Smaller airways can lead to louder snoring. Airflow may be obstructed by:
    • Weak muscles in the tongue and throat
    • Enlarged tonsils, adenoids, or other obstructions (that is, tumors or cysts)
    • Excessive tissue around the throat due to obesity
    • Structural factors:
      • A long, soft palate (roof of the mouth)
      • A long uvula
      • Deformities of the nose or nasal septum
      • Small chin, overbite, or high palate (in women)
    • Congested nasal passages from a cold, flu, sinus infection, or allergies

    Risk Factors

    Factors that may increase your risk of snoring include:
    • Sex: male
    • Being overweight
    • Age: over 50
    • Family history
    • Use of drugs (central nervous system depressants) or alcohol that act as respiratory depressants
    • Lying on back while sleeping
    • Nasal obstruction (due to a cold, sinus infection, allergy, enlarged adenoids, or injury that has displaced the nasal cartilage or bones)

    Symptoms

    The main symptom of snoring is noisy breathing during sleep.
    Snoring may be associated with a sleep condition called sleep apnea. Snoring with sleep apnea may cause these symptoms:
      While sleeping:
      • Gasping
      • Choking
      • Long pauses in breathing
      • Frequent awakening
      While awake:
      • Sleepiness and fatigue during the day
      • Slowness in mental functioning
      • Headaches

    When Should I Call My Doctor?

    Call your doctor if you snore and you have other symptoms of sleep apnea. Talk to your doctor if you have regular snoring that is bothering you or your partner.
    If your child is snoring regularly, talk to their doctor.

    Diagnosis

    If your snoring is severe, the doctor will want to make sure you do not have obstructive sleep apnea. Diagnosis may involve:
    • Physical exam of the throat, neck, mouth, and nose
    • A sleep study in a laboratory—to help determine how much the snoring is disrupting your sleep

    Treatment

    In cases of snoring without sleep apnea, lifestyle changes may alleviate symptoms. More severe cases may require surgery or devices.

    Lifestyle Changes

    Changes that may help stop snoring include:
    • If you are overweight, lose weight.
    • Exercise to improve muscle tone.
    • Avoid drinking alcohol or taking sedatives.
    • Establish regular sleeping patterns.
    • Sleep on your side rather than on your back.
    • Treat causes of nasal congestion (such as, allergies or colds).
    • Raise the head of the bed up about four inches. Use extra pillows or put something under the mattress.

    Surgery

    Surgery may be done to remove excess tissue in the nose or throat. During surgery, a laser or scalpel will remove the tissue that is blocking the airway. Treatment by laser surgery requires a series of surgeries. These surgeries are usually reserved for severe and disruptive cases of snoring.
    Another procedure is to try to stiffen the roof of the mouth.

    Devices

    Devices that can open airways during sleep include:
    • Continuous positive airway pressure (CPAP)—airway is propped open by a continuous flow of air. The air passes through a mask-like device that you wear during sleep. It is more commonly used for people with obstructive sleep apnea.
    • Mouthpieces—to help position the soft palate and tongue for better breathing

    Prevention

    You can take the following steps to help prevent snoring:
    • Maintain a healthy body weight.
    • Treat cold and allergy symptoms.
    • Avoid drinking alcohol or taking sedatives for several hours before bedtime.
    • Sleep on your side.

    RESOURCES

    American Academy of Otolaryngology—Head and Neck Surgery http://www.entnet.org

    National Center on Sleep Disorders Research http://www.nhlbi.nih.gov

    CANADIAN RESOURCES

    Better Sleep Council Canada http://www.bettersleep.ca

    Canadian Lung Association http://www.lung.ca

    References

    Snoring. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/snoring.cfm. Accessed August 14, 2012.

    Beers MH. The Merck Manual of Medical Information. 2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2003.

    Snoring. Nemours Kids Health website. Available at: http://kidshealth.org/kid/health%5Fproblems/teeth/snoring.html. Accessed August 14, 2012.

    McDonald JP. A review of surgical treatment for obstructive sleep apnoea/hypopnoea syndrome. Surgeon. 2003;1:259-264. Review.

    Obstructive sleep apnea. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated July 2009. Accessed August 14, 2012.

    Sher AE. Upper airway surgery for obstructive sleep apnea. Sleep Med Rev. 2002;6:195-212. Review.

    Yaggi HK, Concato J, et al. Obstructive sleep apnea as a risk factor for stroke and death NEJM. 2005;353:2034-2041.

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