Snoring | Is It an Alarm For Something Big?

Snoring | Is It an Alarm For Something Big?

Snoring is the harsh sound or noise from the nose or mouth during sleep due to partial obstruction of breathing.


Who is more prone to snoring?
Age plays an important role in snoring. Snoring gets worse with age. Hence, middle-aged individuals are more prone to snoring.
It is more common in men and people who are overweight. Due to the increased fat in the neck area, the muscles lining the airway relax more when compared to lean body weight individuals leading to narrowed airways.
Snoring can be seen in pregnant women due to hormonal changes and increased body weight.


Is snoring healthy?
Snoring is caused due to obstruction of the airways. Snoring once in a while is common. But sometimes, when snoring is daily and chronic, it can be a concern, as snoring can be a symptom of an underlying health condition such as obstructive sleep apnea (OSA). Also, snoring in the long term can increase the risk of heart attack, stroke and other health-related problems.


What causes snoring?
Snoring can be due to several factors like:

  • Nasal congestion due to common cold, sinusitis, seasonal allergy and other respiratory conditions
  • Structural variation of the nose or soft palates (muscles in the roof of the mouth) such as enlarged tonsils, long palate or uvula
  • Alcohol consumption
  • Drugs such as muscle relaxants
  • Sleep posture- sleeping on your back increases the chances of snoring
  • Lack of sleep- this causes increased relaxation of the throat
  • Family history of snoring
  • Deviated nasal septum
  • Overweight


Can snoring be a symptom of a sleep disorder?
Sometimes snoring can be a symptom of other underlying disease conditions such as obstructive sleep apnea (OSA).
If snoring is associated with any of the symptoms mentioned below, it is better to consult a doctor to further evaluate for OSA.

  • Paused breathing during sleep
  • Excessive daytime sleep
  • Difficult to concentrate
  • Headaches in the morning
  • Increased blood pressure
  • Restless sleep
  • Sore throat after waking up
  • Loud snoring
  • Chest pain during the night
  • Waking up from sleep due to difficulty breathing
  • Poor sleep
  • Periods of apnea (cessation of airflow) and hypopnea (partial airway closure).


How is snoring diagnosed?
Snoring is generally diagnosed based on the signs and symptoms. Generally, the patients would not know about their symptoms. Hence, their partners would be requested to answer the questions regarding the signs and symptoms of the patient. The doctor may ask questions such as the number of snoring per hour, frequency, pitch, time of snoring, etc.
The physician may even ask for the medical and family history of the patient and perform a physical examination.
Other tests include X-ray, CT scan or MRI, which help check the structure of the airways that might contribute to snoring.


Based on the severity of the snoring, your physician may perform a sleep study known as polysomnography. This procedure is usually carried out in a clinic or hospital wherein the patient has to stay in a hospital setting overnight. The doctor would note the severity of the snoring and other associated symptoms of the patient, such as-

  • Brain waves
  • Blood oxygen level
  • Heart rate
  • Rate of breathing
  • Stages of sleep
  • Eye movements

Ways to reduce or stop snoring naturally:

Lifestyle changes – This is the first-line treatment for snoring.

  • Weight reduction in case of overweight.
  • Sleep posture- It is better to sleep on your side rather than on the back.
  • Avoid taking alcohol and other sedatives before bedtime.
  • Treat symptoms of nasal congestion.
  • It is better to get an adequate amount of sleep.
  • Dust on pillows and bedsheets can cause allergic reactions that may cause snoring.
  • Stay well hydrated as dehydration may thicken the mucus in the nasal passages that can contribute to snoring.
  • Raise the head of your bed with pillows to help keep the airways open.


What is Continuous Positive Airway Pressure (CPAP)?
In this approach, a patient will have to wear a mask (connected to a small bedside pump that generates pressurized air) to cover the nose or mouth during sleep, which will help keep the airway open while sleeping. It is the most reliable and effective technique in patients with OSA. It is expensive and some people may feel uncomfortable or have trouble using the device.

Other treatment options for snoring:
Oral appliances for snoring: These are easy, simple, efficient and less expensive alternative approaches to the CPAP technique in patients with OSA. An oral appliance or device, such as a customized mouthpiece, will be given to you by your dentist based on the anatomy of your mouth. It will help to keep the lower jaw, tongue and soft palate forward while sleeping. Dental visits at least once every six months in the first year and annually thereon are necessary. Dry mouth, excess salivation, pain in the jaw and discomfort in the face can be associated with these oral appliances.


Anti-snoring devices such as nasal strips or nasal dilators are available. Nasal strips are adhesive strips which are to be applied on the bridge of the nose (nasal strip) or across the nostrils (external nasal dilator) that may help increase the nasal passage and decrease the airflow resistance, thereby improving breathing. But they may not be very effective in people with OSA.

Can snoring be gone with surgery?
Several procedures help to reduce snoring

  • Laser-assisted uvula palatoplasty (LAUP) – in this procedure, the tissues of the soft palate are reduced to improve airflow during sleep.
  • Radiofrequency ablation – this technique requires low-intensity radiofrequency to shrink the tissues of the soft palate, tongue and nose.
  • Tonsillectomy and adenoidectomy – in these procedures, the excess tissues present in the back of the throat (tonsillectomy) or nose (adenoidectomy) will be removed.
  • Septoplasty – in this procedure, the deviated septum will be straightened, which will help to improve the airflow.
  • Hypoglossal nerve stimulation – a stimulus will be applied to the nerves that will prevent the tongue from falling back and therefore prevent airway obstruction.
  • Functional Endoscopic Sinus Surgery – it can be helpful if snoring is due to the obstruction in the nasal passages due to sinus issues. The extra tissues in the nasal and sinus area will be removed for easy breathing


Complications of snoring:
If snoring is associated with OSA, then it may cause further complications such as

  • Decreased concentration
  • Agitation and anxiety
  • Restlessness
  • Fatigue
  • Day time sleeping
  • Decreased blood oxygen levels
  • Increased risk of hypertension (increased blood pressure), diabetes, stroke, heart attack and other heart conditions


References:

  1. Kotecha, B., & Shneerson, J. M. (2003). Treatment options for snoring and sleep apnoea. Journal of the Royal Society of Medicine, 96(7), 343–344. https://doi.org/10.1258/jrsm.96.7.343
  2. Kaur, S., Baslas, V., Aggarwal, H., Kumar, P., & Chand, P. (2015). Snoring: an annoyance or a serious health problem (obstructive sleep apnea)?. Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine, 40(2), 143–144. https://doi.org/10.4103/0970-0218.153889
  3. Stuck, B. A., & Hofauer, B. (2019). The Diagnosis and Treatment of Snoring in Adults. Deutsches Arzteblatt international, 116(48), 817–824. https://doi.org/10.3238/arztebl.2019.0817
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