Snoring

Snoring

Snoring is the action or sound of breathing during sleep that is characteristically harsh and loud.  Some people even make snorting noises when they snore. Snoring happens because the relaxed tissues in your throat vibrate as the air you breathe in rushes past them.  It is a common sleep problem that can affect anyone, but it more frequently occurs with men and with people who are overweight or obese. It also can be an issue secondary to a medical condition, such as a nasal airway obstruction like a deviated septum or enlarged nasal turbinates.

What Causes Snoring?

Snoring occurs when the flow of air through the mouth and nose is physically obstructed.  A combination of factors can obstruct airflow, including:

Obstructed nasal airways due to

  • Allergies
  • Enlarged tongue base
  • Sinus Infection
  • Deviated Septum
  • Inferior turbinate hypertrophy
  • Nasal Polyps

Poor muscle tone in the throat and tongue due to

  • Muscles are too relaxed
  • Deep sleep
  • Alcohol consumption
  • Sleeping pills
  • Normal aging

Bulky throat tissue due to

  • Being overweight
  • Enlarged tonsils and adenoids

Long soft palate and/or uvula cause

  • Structures to vibrate and bump against one another causing airway obstruction

When is Snoring Harmless?

Snoring isn’t always a sign of a more significant health issue. Sometimes people snore because they have a cold or they have a sinus infection. Other times it may be due to allergies or having a nightcap before bed.  These are harmless occurrences that you don’t need to worry about.

When is Snoring Harmful?

Habitual snoring is more of an issue if the snorer is experiencing any of the following symptoms:

  • Excessive daytime drowsiness
  • Waking up not feeling rested
  • Morning headaches
  • Recent weight gain
  • Chest pain at night
  • High blood pressure
  • Decreased ability to concentrate or memory loss
  • Observed pauses in breathing at night
  • Waking up gasping for breath

These signs and symptoms may indicate a potential health issue.

How Can Snoring Impact Your Life?

If you are a habitual snorer, snoring can disrupt your own sleep quality as well as the sleep patterns of your bed partner.  Good sleep is important for physical and mental health. Without regular and adequate sleep, you will have a sleep deficiency and many body systems can start to malfunction (i.e., hormonal imbalance, elevated blood sugar levels, and impaired immune system).  Snoring may also be an indicator of a more serious health issue, such as obstructive sleep apnea (OSA).

The lack of quality sleep has an impact on personal relationships as well, leading to irritability and arguments, as well as affecting one’s ability to work effectively.  Some couples end up sleeping in separate bedrooms or end up in divorce.

Fortunately, medical assistance is available to help you and your bed partner get a good night’s sleep.

Are there Complications Associated with Snoring?

If habitual snoring is associated with OSA, you may be at risk for other complications, including high blood pressure, heart conditions, stroke, and type 2 diabetes.

What is the Prevalence of Snoring in the US?

In 2009, the Centers for Disease Control and Prevention (CDC) conducted a study to assess the prevalence and distribution of selected sleep difficulties and behaviors.  They analyzed data from a new sleep module added to the Behavioral Risk Factor Surveillance System (BRFSS), and the results of that analysis indicated that among 74,571 adult respondents in 12 states, 35.3% reported having <7 hours of sleep on average during a 24-hour period, 48% reported snoring, 37.9% reported unintentionally falling asleep during the day at least 1 day in the preceding 30 days, and 4.7% reported nodding off or falling asleep while driving in the preceding 30 days.

Further details of this report indicated that of the 48% that reported snoring, persons aged 18-24 years were least likely (25.6%) to report snoring, Hispanics (50.6%) were more likely to report snoring than non-Hispanic whites (46.8%), as were men (56.5%) compared with women (39.6%).

This report was the first to present estimates of the prevalence of unhealthy sleep-related behaviors, and the need to increase public awareness of the effects on health and quality of life.

Who Should You See for Your Snoring Issues?

You should see an ENT (ear, nose, and throat) doctor to assess your snoring problem, as they specialized in nasal airway obstruction problems that may be causing your snoring.

How are Health Issues Associated with Snoring Diagnosed?

Your ENT doctor will review your signs and symptoms and your medical history, as well as perform a physical examination.  Your doctor may even ask your bed partner some questions about when and how you snore to help assess the severity of the problem.

In addition, your doctor may order an imaging test, such as an x-ray, a CT (computerized tomography) scan, or MRI (magnetic resonance imaging) to check the structure of your airway for problems, such as a deviated septum.

Depending on the severity of your symptoms, your doctor may also order a sleep study for you, which can be done at home or at a sleep clinic.  During a sleep study, you are connected to many sensors that will do an in-depth analysis of your breathing, recording your brain waves, blood oxygen level, heart rate, breathing rate, sleep stages, eye and leg movements.

What Treatment Options are Available?

There are several treatment options available to treat your snoring. Initially, your doctor will recommend some lifestyle changes such as:

  • Losing weight
    • Includes a dietary modification and exercise regimen
  • Avoiding alcohol close to bedtime
  • Treating nasal congestion
    • Use nasal decongestants and nasal steroid sprays
    • Follow up with an allergist for long-term management
  • Implementing good sleep habits
  • Avoiding sleeping on your back

If your snoring is associated with OSA, your doctor may recommend the following:

Oral Appliances – form-fitting mouthpieces that help advance the position of the jaw, tongue and soft palate to keep your air passage open. Your dentist or an oral surgeon can help you with these fittings.

Continuous Positive Airway Pressure (CPAP) – is a mask you wear over your nose and mouth while you sleep.  The mask directs pressurized air from a small bedside pump to your airway to keep it open during sleep.

Upper Airway Surgery – there are a number of procedures that can be done to open the airway and prevent significant narrowing during sleep.

A UPPP (uvulopalatopharyngoplasty) is done under general anesthesia. Your surgeon tightens and trims excess tissues from your throat.

An MMA (maxillomandibular advancement) procedure involves moving the upper and lower jaws forward, which helps open the airway.

An RFA (radiofrequency ablation) is an office-based procedure done under local anesthesia that uses a low-intensity radiofrequency signal to stiffen the soft palate and reduce tissue vibration and snoring.

A Pillar Procedure is performed under local anesthesia and takes around 20-30 minutes to perform in the office setting.  Small implants are placed into the soft palate to diminish tissue vibration, thereby reducing snoring.

A hypoglossal nerve stimulation procedure employs a stimulus applied to the nerve that controls the forward movement of the tongue, so the tongue does not block the airway when you breathe.

Nasal Airway Surgery – there are a number of nasal airway surgeries that can be done in the office or in the operating room.   When the nasal airway contributes to snoring, treatment options include straightening the deviated septum, shrinking the enlarged inferior turbinates, repairing the nasal valve collapse, or removing the enlarged adenoids. These procedures may be performed in the office or in the operating room depending on several factors, including the severity and location of the blockage.

Contact Us

If you or a loved one has an issue with snoring, contact CT Sinus Center at (203) 574-5997 for consultation, diagnosis, and treatment recommendation.

Sources

  1. https://www.enthealth.org/be_ent_smart/treatment-options-for-adults-with-snoring/
  2. https://www.cdc.gov/mmwr/PDF/wk/mm6008.pdf