Almost everyone snores occasionally. Habitual snoring occurs in around 40% of adult women and 57% of adult men, and some people snore regularly without any other sleep-related symptoms. However, snoring can be caused by a sleep disorder called sleep apnea, which disrupts sleep and can lead to other health issues. Snoring may also be the result of a person’s natural anatomy and weight, or behaviors such as drinking alcohol or sleeping in a certain position. Understanding the varied causes of snoring can help you determine whether your snoring is something you should be concerned about, and what steps you can take to address it.
Snoring happens when air cannot flow freely through the airway as you breathe in and out during sleep. When the airway is narrowed or partially blocked, breathing causes the tissues of the upper airway to vibrate, resulting in the sound you hear when someone snores. There are many possible reasons that a person may have a chronically narrowed or blocked airway during sleep that causes snoring.
Obstructive Sleep Apnea
Not everyone who snores has obstructive sleep apnea (OSA), but most people with OSA snore. OSA is a common sleep-related breathing disorder that frequently goes undiagnosed. OSA is marked by repeated pauses in breathing during sleep due to partial or complete collapse of the airway. People with sleep apnea tend to snore loudly with periods of silence as breathing stops. When they resume breathing, it can sound like gasping or snorting.
OSA is associated with adverse health outcomes such as depression, high blood pressure, and heart disease. Sleepiness during the day can also lead to accidents while driving or while at work. Fortunately, OSA treatment can successfully resolve symptoms and reduce one’s risk for harmful health effects. Treatment for OSA includes the use of continuous positive airway pressure (CPAP) devices, lifestyle changes, dental devices, and surgery.
Alcohol and Sedative Medication
Alcohol and other sedatives cause snoring by relaxing the muscles that support tissue around the airway. So, chronic snorers, including those with OSA, who drink alcohol experience more severe snoring. Physicians often recommend avoiding alcohol and sedative medications during the hours leading up to bedtime to reduce snoring. Although this approach to snoring management has not been evaluated in a randomized clinical trial, some people may experience benefits.
Cigarette smoking is another risk factor for snoring. It’s not clear exactly why people who smoke are more likely to snore, but researchers propose that it may be due to upper airway inflammation and edema in smokers. Quitting smoking has been shown to improve snoring, but it can take time. A study showed that snoring rates remained elevated in people who quit recently but within four years declined to match the rates seen in people who had never smoked.
Head and Neck Anatomy
The size and shape of certain structures can constrict the airway and lead to snoring. For example, people are more likely to snore if they have a deviated septum, which is when the wall between nostrils is bent or skewed to one side. Additionally, growths in the nasal passages called polyps, having a small jaw, and having an enlarged tongue or tonsils can contribute to snoring.
Treatment approaches for people who have one of these anatomical causes of snoring include surgery and dental devices. Both methods aim to increase the flow of air in and out of the airway during sleep. These approaches have been shown to be effective in some patients with OSA, but further research is needed to show whether they’re effective in people who snore but don’t have OSA.
Chronic Nasal Congestion
Having a stuffy nose during sleep may lead to snoring by reducing the flow of air through the airway and causing the airway to collapse. Allergy or infection are the most common causes of nasal congestion, but other contributors include being in a dry air environment or having a deviated septum. When these conditions persist over time, nasal congestion can become chronic and lead to habitual snoring. A study of middle-aged adults found that those who indicated that they experienced nasal congestion at night “always” or “almost always” were three times more likely to be habitual snorers.
Treatment for snoring due to chronic congestion depends on the cause but may include using nasal decongestants or nasal steroids.
Snoring occurs more often when you are laying on your back, also called supine position. When you are on your back, gravity pulls the tissues surrounding your airway downward, which makes the airway more narrow. Research on snorers has shown that the frequency and intensity of snoring decreases in some patients when they lay on their side, also called lateral position.
There are a variety of approaches to positional therapy to treat snoring and sleep apnea. Positional therapy encourages sleepers to avoid sleeping on their backs. These include positional alarms, modified nightshirts, and lateral sleep pillows. Data also suggests that using a special pillow designed to keep the head to the side can decrease snoring.
Having extra tissue in the neck can lead to a smaller airway size and an increased susceptibility to airway collapse. Weight loss may improve snoring in individuals who are overweight. A study found that men who lost at least six pounds experienced reductions in the frequency of their snoring, with greater weight losses being associated with near elimination of snoring.
Older age is associated with a number of sleep changes, including increased snoring. The tongue and the muscles that surround the airway may become weaker as we get older. Engaging in mouth and throat exercises, also called myofunctional therapy, may reduce snoring caused by weak muscles. A review of studies found that myofunctional therapy reduced snoring intensity and frequency.
Hypothyroidism is a condition in which the thyroid gland under-functions and does not produce enough thyroid hormone. If left untreated, it leads to symptoms such as a puffy face, hoarse voice, slow speech, and slow heart rate. It can also contribute to snoring. Researchers administered sleep studies in twenty hypothyroidism patients and found that all of them snored. Treatment for hypothyroidism involves taking a medication that replaces the thyroid hormone deficiency.
When Should You Speak With a Doctor About Snoring?
A potential health concern for someone who snores is that snoring may be a sign of sleep apnea. If you snore and also have any of these other OSA symptoms, it’s a good idea to speak with a doctor:
- Pauses in breathing during sleep followed by choking, snorting, gasping sounds
- Waking up frequently at night
- Daytime sleepiness
- Morning headaches
Snoring often goes unnoticed by the snorer; rather, a bed partner or housemate alerts the affected individual about their snoring and other nighttime OSA symptoms. It could also be helpful to talk with a doctor if your snoring is affecting your bed partner’s sleep and you would like to explore treatment options.
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