Definition and Overview

Snoring is a hoarse, often loud breathing caused by the vibration of the soft palate during sleep. It occurs when the flow of air through the nose and mouth is obstructed. Although snoring is a common condition, especially among the elderly and those who are overweight, it does not necessarily imply that you have a health problem. However, when severe, snoring can result in sleep disruption. Snoring may also be a sign of obstructive sleep apnea. Approximately 30-50% of adults snore. This number increases with age, with snoring occurring in as much as 60% of adults above 60 years old.

Cause of Condition

The vibration of the soft palate in the neck region causes snoring when the person is asleep. This occurs due to an obstruction in the passage or movement of air when breathing. Obstruction of the airways during sleep may be due to several factors. It could be due to a stuffed nose or the development of nasal masses or polyps. People who are overweight and obese also tend to snore, because the additional tissues in the neck place more pressure in their airway. Other causes include weakness of the throat muscles and swelling of the structures located at the back of the mouth, such as the uvula, the tonsils and the soft palate. Abnormalities in facial or nasal structure, such as a malpositioned jaw and malalignment of the nasal septum, such as in patients with a crooked nose or a deformed septum, can likewise lead to snoring.

Key Symptoms

Snoring may actually be a symptom of a health problem known as obstructive sleep apnea. This is a condition where a person suddenly stops breathing while he is sleeping. The episode usually lasts for more than ten seconds and is then followed by a sudden gasp or snort. This cycle can occur several times throughout the night.

Obstructive Sleep Apnea (OSA) can result in a number of complications such as hypoxemia or low levels of oxygen in the blood. It can also result in poor sleep quality and sleep deprivation. Having OSA increases a person's risk of developing hypertension, heart diseases and stroke by at least 30%. In children, it has been associated with poor performance in school, growth problems, and difficulties in learning. Approximately 75% of individuals who snore actually have sleep apnea.

Who to See and Types of Treatments Available

Most people who are snoring do not necessarily require medical attention. Less serious snoring can be managed and minimized through simple lifestyle modification and various sleeping techniques. Increasing water intake and avoiding cigarette smoking are proven to be helpful as they prevent nasal secretions from becoming too sticky.

Other proven techniques to minimize snoring are sleeping on the side with the head extended to open up the airways, using over-the-counter nasal sprays or nasal strips, and losing weight. The effectiveness of these tips varies from one patient to another.

However, snoring can become a serious health problem. If you wake up gasping or if you do not feel rested when you wake up in the morning, or if you experience drowsiness, headaches, fatigue and loss of concentration during the day, consulting a health care provider or a sleep specialist becomes necessary. A physical examination that is focused on your throat, nose and mouth will be performed. Your doctor may also conduct a sleep study test to check if you have obstructive sleep apnea.

After the causes of your snoring have been identified, your physician will formulate a treatment plan. Treatment options may include the use of special dental instrument called mandibular advancement splint, which allows the lower jaw to move forward together with the tongue. This is a good option for patients who experience mild to moderate degrees of sleep apnea.

Your health care provider may also recommend the use of continuous positive airway pressure equipment. This equipment is attached to a machine that pumps oxygen through a hose, which is connected to a mask that is placed over your nose and mouth. This device keeps the air passages open and minimizes snoring.

There are also several surgical options designed to stop snoring, with varying degrees of success. If you have a deviated nasal septum, you may be advised to undergo a nose surgery in order to correct it. You may also be advised to undergo an elective tonsillectomy. A uvulopalatopharyngoplasty is another operation that involves the removal of the tissues at the back of the throat to widen the airway.

Another surgical technique is the Pillar procedure. In this operation, strips of prosthetic material are placed in the soft palate, making it more rigid. A newer method uses radiofrequency ablation, also known as RFA. This uses heat energy to stiffen the structures at the back of the throat.

References:

  • National Sleep Foundation. https://www.sleepfoundation.org
  • Gozal D. et al. “Diagnostic Capability of Biological Markers in Assessment of Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis.” Journal of Clinical Sleep Medicine.
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