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 Forty-five percent of
normal adults snore at least occasionally, and 25 percent are
habitual snorers. Problem snoring is more frequent in males and
overweight persons, and it usually grows worse with age.
More than 300 devices are registered in the U.S. Patent and
Trademark Office as cures for snoring. Some are variations on
the old idea of sewing a sock that holds a tennis ball on the
pajama back to force the snorer to sleep on his side. (Snoring
is often worse when a person sleeps on his back). Some devices
reposition the lower jaw forward; some open nasal air passages;
a few others have been designed to condition a person not to
snore by producing unpleasant stimuli when snoring occurs. But,
if you snore, the truth is that it is not under your control
whatsoever. If anti-snoring devices work, it is probably because
they keep you awake.
The noisy sounds of snoring occur when there is an obstruction
to the free flow of air through the passages at the back of the
mouth and nose. This area is the collapsible part of the airway
(see illustration) where the tongue and upper throat meet the
soft palate and uvula. Snoring occurs when these structures strike
each other and vibrate during breathing.
- When muscles are
too relaxed, either from alcohol or drugs that cause sleepiness,
the tongue falls backwards into the airway or the throat muscles
draw in from the sides into the airway. This can also happen
during deep sleep.
- Children
with large tonsils and adenoids often snore. Overweight people have bulky
neck tissue, too. Cysts or tumors can also cause bulk, but they are rare.
- A
long palate narrows the opening from the nose into the throat. As it
dangles, it acts as a noisy flutter valve during relaxed breathing.
A long uvula makes matters even worse.
- A
stuffy or blocked nose requires extra effort to pull air through
it. This creates an exaggerated vacuum in the throat, and pulls
together the floppy tissues of the throat, and snoring results.
So, snoring often occurs only during the hay fever season or
with a cold or sinus infection.
Also, deformities of the nose or nasal septum, such as a deviated
septum (a deformity of the wall that separates one nostril from
the other) can cause such an obstruction.
Socially, yes! It can be, when it makes the snorer an object
of ridicule and causes others sleepless nights and resentfulness.
Medically, yes! It disturbs sleeping patterns and deprives the
snorer of appropriate rest. When snoring is severe, it can cause
serious, long-term health problems, including obstructive sleep
apnea.
When loud snoring is interrupted by frequent episodes of totally
obstructed breathing, it is known as obstructive sleep apnea.
Serious episodes last more than ten seconds each and occur more
than seven times per hour. Apnea patients may experience 30 to
300 such events per night. These episodes can reduce blood oxygen
levels, causing the heart to pump harder.
The immediate effect of sleep apnea is that the snorer must
sleep lightly and keep his muscles tense in order to keep airflow
to the lungs. Because the snorer does not get a good rest, he
may be sleepy during the day, which impairs job performance and
makes him a hazardous driver or equipment operator. After many
years with this disorder, elevated blood pressure and heart enlargement
may occur.
Heavy snorers, those who snore in any position or are disruptive
to the family, should seek medical advice to ensure that sleep
apnea is not a problem. An otolaryngologist will provide a thorough
examination of the nose, mouth, throat, palate, and neck. A sleep
study in a laboratory environment may be necessary to determine
how serious the snoring is and what effects it has on the snorer's
health.
Treatment depends on the diagnosis. An examination will reveal
if the snoring is caused by nasal allergy, infection, deformity,
or tonsils and adenoids.
Snoring or obstructive sleep apnea may respond to various treatments
now offered by many otolaryngologist-head and neck surgeons:
- is surgery for treating
obstructive sleep apnea. It tightens flabby tissues in the throat
and palate, and expands air passages.
- refers
to procedures and techniques that treat snoring and some of them also are
used to treat various severities of obstructive sleep apnea. Different
types of TAP include bipolar cautery, laser, and radiofrequency.
Laser Assisted Uvula Palatoplasty (LAUP) treats snoring and
mild obstructive sleep apnea by removing the obstruction in
the airway. A laser is used to vaporize the uvula and a specified
portion of the palate in a series of small procedures in a
doctor's office under local anesthesia. Radiofrequency ablation-some
with temperature control approved by the FDA-utilizes a needle electrode
to emit energy to shrink excess tissue to the upper airway including the
palate and uvula (for snoring), base of the tongue (for obstructive sleep
apnea), and nasal turbinates (for chronic nasal obstruction).
- is
a surgical procedure for the treatment of sleep apnea. It prevents collapse
of the lower throat and pulls the tongue muscles forward, thereby opening
the obstructed airway.
If surgery is too risky or unwanted, the patient may sleep every
night with a nasal mask that delivers air pressure into the throat;
this is called continuous positive airway pressure or "CPAP".
A chronically snoring child should be examined for problems
with his or her tonsils and adenoids. A tonsillectomy and adenoidectomy
may be required to return the child to full health.
Adults who suffer from mild or occasional snoring should try
the following self-help remedies:
- Adopt a healthy and athletic lifestyle to develop
good muscle tone and lose weight.
- Avoid tranquilizers,
sleeping pills, and antihistamines before bedtime.
- Avoid
alcohol for at least four hours and heavy meals or snacks
for three hours before retiring.
- Establish regular sleeping
patterns
- Sleep on your side rather than your back.
- Tilt the head
of your bed upwards four inches.
Remember, snoring means obstructed breathing, and obstruction
can be serious. It's not funny, and not hopeless.
© 2004 AAO-HNS/AAO-HNSF
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