Snoring occurs in roughly 57% of adult men and 40% of women. Of these, one quarter are considered habitual snorers. About 10-12% of children also snore. Snoring on its own is usually considered a harmless – albeit highly disruptive – phenomenon, but for some people it indicates a more serious underlying medical condition or sleep disorder.
When To See a Doctor About Snoring
Snoring occurs when airflow is blocked or restricted in the nasopharynx, an area of the upper airway located behind your nose. Tissues in the airway flutter and strike each other to produce the telltale snoring sound, which can range from light and barely audible to heavy and disruptive.
For some people, heavy snoring indicates the presence of sleep apnea, a sleep-related breathing disorder that causes people to choke or gasp for air in their sleep. Snoring is considered the chief symptom of obstructive sleep apnea (OSA), a condition attributed to a physical blockage that restricts respiratory activity in the upper airway.
Roughly 2-9% of adults live with OSA. Episodes involving a complete loss of airflow are called apneas, and episodes with reduced airflow are known as hypopneas. Apneas and hypopneas occur five to 15 times per hour in people with mild OSA, 16 to 30 times per hour in those with moderate OSA, and more than 30 times per hour in those with severe OSA.
Considering each apnea normally lasts at least 30 seconds, even mild OSA can be disruptive to the sleeper and anyone who shares their bed. Snoring may accompany apnea-hypopnea episodes or occur independently during the night. Excessive daytime sleepiness from not getting enough rest is another common symptom of OSA.
Risk factors for OSA include:
- Obesity: Obese people may be susceptible to OSA if they have fat deposits around the neck that restrict the upper airway.
- Enlarged tonsils or adenoids: Due to their placement around the upper airway, tonsils and adenoids can both block the upper airway if they are large enough. For many children with OSA, removing the tonsils and/or adenoids will help alleviate their symptoms.
- Endocrine disorders: The endocrine system releases hormones that can interfere with breathing during sleep. Hypothyroidism, a condition characterized by low levels of thyroid hormone, and acromegaly, which causes high growth hormone levels, are both associated with sleep apnea. Hypogonadism, a condition with decreased testosterone production, when treated with testosterone replacement treatment, can worsen sleep apnea in men.
- Genetic syndromes: Some genetic syndromes affect how the face and jaw are structured, leading to airway restriction. Some examples include cleft lip and cleft palate, Down syndrome, and congenital central hypoventilation syndrome.
Based on testing for at least five apnea-hypopnea episodes per hour, roughly 24% of men and 7% of women live with sleep apnea. Obese people and the elderly are considered at higher risk for OSA. It’s also believed that consuming alcohol or sedating medications before bed can exacerbate OSA symptoms.
Central sleep apnea, which occurs when the brain cannot properly signal the muscles that control breathing, may also produce snoring, but this is less common. Another sleep disorder, upper airway resistance syndrome, can cause snoring due to airway restriction but does not include apnea or hypopnea episodes. Additionally, sleep-related bruxism – also known as nocturnal teeth-grinding – is associated with snoring, particularly in children.
Any sleep disorder should be taken seriously. If you or your partner are concerned about heavy snoring, you should schedule a visit with your doctor to discuss the situation. People with OSA often benefit from continuous positive air pressure (CPAP) therapy, which administers air that is pressurized at a prescribed rate to ease breathing during the night.
Other Causes of Snoring
While snoring does not necessarily indicate the presence of a sleep disorder, it can disrupt sleep for you and your partner. Snoring is associated with obesity and old age even for those who do not have sleep apnea symptoms. Other risk factors for snoring include:
- Consumption of sedatives like alcohol and sleep-inducing medications
- Chronic nasal congestion or blockage
- A relatively small or displaced jaw
- Postmenopausal status
Another common cause of snoring is back sleeping, which can affect breathing by restricting the airway. People who snore are often encouraged to sleep on their sides instead.
How To Treat Snoring
You may be able to reduce your snoring by making certain lifestyle changes. These include losing weight, avoiding alcohol and sedative medications at night, and always sleeping on your back. Since nasal congestion can cause breathing, treating this with decongestants or corticosteroid sprays may be effective if your doctor approves them.
People who see their doctor about snoring may be evaluated for sleep apnea. The examination may include an examination of the nose and mouth to check for a physical obstruction, as well as other warning signs such as nasal polyps, a high or narrow arched palate, a displaced jaw, or enlarged tonsils or adenoids.
Anti-snoring mouthguards have proven effective for some people. Tongue-retaining devices (TRDs) form a seal around the tongue and hold it in place. These appliances can alleviate snoring for people whose tongues tend to fall in the back of their throat when they sleep. Mandibular advancement devices (MADs) physically move the tongue and jaw forward, allowing for maximum airflow.
In certain cases, surgery may be advised. During a uvulopalatopharyngoplasty procedure, the patient’s uvula, palate, and pharyngeal walls are removed to create more space for the upper airway. However, this is a procedure that requires general anesthesia and may not be the most practical – or cost-effective – way to correct snoring.
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