Snoring: What You Need to Know

So, you’ve been told that you sound like you’re sawing logs, a freight train, or bear while you sleep. Should you be concerned if you snore? What can you do about snoring?


What causes snoring?

Snoring is caused by vibration of the tissues in the upper airway typically while you are breathing air in. When you are asleep, your muscles relax, which may increase narrowing of the area between the back of your tongue and throat. The air that you breathe in and out may become turbulent around these floppy, narrow tissues, leading to vibration. Anything that can narrow or relax the space of the upper airway can lead to snoring. Obesity, having a large neck size, smoking, pregnancy, nasal problems, large tonsils, and alcohol use are just a few examples of potential causes.


How common is snoring?

According to a report by the CDC, about 50% of adults report snoring. However, snoring is underreported since many people do not know they snore, so the actual prevalence of snoring is suspected to be much higher. It is more common in men.


Should you be concerned if you snore?

The biggest concern about snoring is whether you have a condition called obstructive sleep apnea (see post What is Sleep Apnea). Most people with obstructive sleep apnea snore, although not everyone who snores has sleep apnea. In a study from 2002, 61% of habitual snorers (snoring 3-7 times/week) and 40% of intermittent snorers (<3 nights/week) had sleep apnea.

Untreated sleep apnea is associated with serious negative health outcomes, including increased risk of high blood pressure, stroke, heart attack, memory problems, cancer, motor vehicle accidents, irregular heartbeat, earlier death, diabetes, and reduced quality of life. If you are having any symptoms concerning for sleep apnea, you should talk to your doctor about consideration of a sleep study.

However, even if you don’t have sleep apnea, snoring alone may be associated with problems. One study demonstrated that snoring, even if not associated with sleep apnea, may increase risk of carotid atherosclerosis (or plaque build-up of the major arteries that carry blood to your brain).


Treatment of snoring

As above, you first want to ensure that you don’t have sleep apnea because treatment options are different if you have sleep apnea, especially if you moderate or severe sleep apnea. Treatment of your sleep apnea should improve and in most cases, resolve your snoring.

Several potential options are available to treat primary snoring (i.e., snoring not associated with sleep apnea), which includes:

  • Avoid substances that relax your muscles while you sleep. These substances include alcohol, opiates, and benzodiazepines, which are sometimes used to treat anxiety.
  • Avoid sleeping on your back. When you sleep on your back, gravity pulls the back of your tongue closer to your throat, narrowing your upper airway. If you can’t avoid sleeping on your back, sleeping with your head slightly inclined may help.
  • Weight loss if you are overweight or obese.
  • Avoid tobacco smoke. Smoking leads to inflammation of the tissues of your upper airway.
  • An oral appliance. A mandibular advancement oral appliance pulls your lower jaw slightly forward opening your upper airway. A tongue retaining device pulls the tongue forward, but many people find this device less comfortable. A dentist with expertise in sleep can assist you with an oral appliance. To find a sleep dentist in your area, you can go to the American Academy of Dental Sleep Medicine’s website here.
  • Theravent. This product may help keep your upper airway open.
  • Treatment of nasal congestion or other nasal symptoms. Improving nasal symptoms may help snoring in some people. However, the data on the effectiveness of treating nasal symptoms is not robust, so spending a lot of money on these nasal treatments may not be the best answer unless your doctor thinks you may benefit. Talk to your doctor if you’re having nasal problems. Your doctor may decide to do further evaluation, prescribe or recommend a medication, or refer you to a specialist such as an allergist or ENT, depending upon your symptoms. Some products available that open the nasal passages include nasal strips and nasal dilators. Examples include the Breathe Right strips that many people are familiar with or Mute nasal dilators.
  • Surgery of the upper airway or nasal area. Most people report that surgery of the upper airway is quite painful. Additionally, the benefits may be short-lived in some people. A study evaluating nasal surgery to treat nasal obstruction also did not lead to decreased snoring intensity or snoring time. Furthermore, any type of surgery can have risks including infection and bleeding. Less invasive options should be considered and tried first.

Snoring may be associated with sleep, affect your health, or disrupt your bed partner’s sleep. Talk to your doctor if you are snoring, especially if it’s occurring more than a couple times a week to see if you need further evaluation.

“Laugh and the world laughs with you; snore and you sleep alone.” – Anthony Burgess

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