Snoring Causes and Treatments

Snoring may be a familiar companion, but just what is snoring and what are the causes and consequences? By understanding some of its basic features you may discover ways to eliminate its presence, especially if it is bothersome to your sleep or the sleep of your loved ones.

What Is Snoring?

Snoring is quite simply the sound produced during sleep by the vibration of the soft tissues in the upper airway, including the nose and throat. It typically happens when a breath is drawn in, but may also occur when breathing out.

Snoring occurs occasionally in nearly everyone, yet many people snore chronically. In people 30 to 60 years old, 44% of men and 28% of women habitually snore. Women are more likely to snore after menopause.

Causes

When snoring is present, it suggests that the nose or throat may be partially obstructed during sleep. This obstruction leads to difficulties moving air. As a result, the air moves turbulently through the airway, which is what causes the vibration and sound of snoring.

If the airway becomes completely blocked, the result is obstructive sleep apnea. Even partial obstructions may lead to hypopnea or upper airway resistance syndrome (UARS), which are milder forms of sleep apnea.

Snoring is associated with other common conditions, including:

• Obesity
• Nasal congestion (allergies and colds)
• Hypothyroidism
• Acromegaly (a disorder in which the body produces too much growth hormone)
• Enlarged tonsils or adenoids
• Abnormal facial development
• Obstructive lung disease (sometimes seen with snoring during expiration or exhaling)

Alcohol is a muscle relaxant that can make snoring worse. In addition, medications that relax muscles (including benzodiazepines used as sleep aids and for anxiety) may have a similar impact.

The Consequences of Snoring

Mild snoring may have little effect on the quality of your sleep. However, as the airway becomes more obstructed, the effort to breathe likewise increases. If breathing is compromised, oxygen levels in the blood will drop. This may lead to temporary arousals and, therefore, disrupted sleep.

Snoring has been found to increase the risk of narrowing of the blood vessels within the neck, a phenomenon called carotid atherosclerosis. In a study of 110 patients, the total sleep time spent snoring, the higher the risk of narrowing. It is thought that direct vibratory damage of the carotid arteries within the neck may lead to increased plaque formation within these blood vessels.

A study published in the journal Sleep in 2016 found that snorers had a reduction in telomere length—a marker of cellular aging and inflammation.

Perhaps the biggest problem with snoring (especially when it is loud) is the disruption of the sleep of others, including your bed partner. This may require special sleep arrangements, such as sleeping in the guest bedroom or on the couch.

Evaluation and Treatment

Snoring may not necessarily raise any concerns. There are some situations where it should be further evaluated, however. As it is associated with other conditions, these may need to be ruled out to ensure that no other health consequences occur.

The initial evaluation for snoring may include a visit to your healthcare provider's office. It may be important for your bed partner or another family to come along so that they may provide details about your snoring and other breathing disruptions during sleep.

Any pauses in your breathing at night should be mentioned as these may suggest sleep apnea. If you have restless sleep or have a sense of choking or gasping, this could be important as well.

Other associated symptoms with sleep apnea may include:

• Excessive daytime sleepiness
• Moodiness (irritability, anxiety, and depression)
• Poor concentration and memory problems
• Morning headaches
• High blood pressure (hypertension)
• Waking to urinate (nocturia)
• Teeth grinding or clenching (bruxism)

In addition, any difficulties related to your sinuses should be evaluated. If you have congestion in your nose, allergies, sinus infections (sinusitis), or a history of sinus surgery, this may require further investigation. If you suffer from frequent sore throats or mouth breathing, you may have enlarged tonsils or adenoids. Difficulties with fatigue, weight gain, cold intolerance, and constipation may suggest hypothyroidism.

A physical examination should include an assessment of the upper airway with measurement of your neck circumference as well as carefully looking at your nose, mouth, and throat. If your healthcare provider suspects you may have sleep apnea, you may need to have a sleep study called a polysomnogram or a home sleep apnea test.

Treatment of snoring is meant to target the underlying condition that is causing you to snore. It may include lifestyle changes such as weight loss or avoiding alcohol before bed, which may relax the airway. Surgery may also be an option, especially if you have a narrow airway because of a deviated septum or enlarged tonsils or adenoids.

Targeting allergies may relieve nasal congestion, as can over-the-counter aids like Breathe Right strips. When associated with sleep apnea, continuous positive airway pressure (CPAP) or an oral appliance may be helpful.

Regardless of the ultimate treatment pursued, if needed, a careful evaluation may provide the reassurance you need to sleep soundly.