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Snoring

Snoring - Overview and Facts

Snoring is the often loud or harsh sound that can occur as you sleep. You snore when the flow of air as you breathe makes the tissues in the back of your throat vibrate. The sound most often occurs as you breathe in air, and can come through the nose, mouth or a combination of the two. It can occur during any stage of sleep.

About half of people snore at some point in their lives. Snoring is more common in men, though many women snore. It appears to run in families and becomes more common as you get older. About 40 percent of adult men and 24 percent of adult women are habitual snorers. Men become less likely to snore after the age of 70.

Sleeping on your back may make you more likely to snore. It may also occur as your throat muscles relax from use of alcohol or other depressants. Congestion from a cold or allergies can also cause you to snore.

Snoring can be a nuisance to your partner and anyone else nearby. You may even snore loudly enough to wake yourself up. Though, in many cases people do not realize that they snore. Snoring can also cause you to have a dry mouth or sore or irritated throat when you wake up.

Light snoring may not disrupt your overall sleep quality. Heavy snoring may be associated with obstructive sleep apnea, a serious sleep disorder and a risk factor for heart disease, stroke, diabetes and many other health problems.

Snoring vs. Sleep Apnea

 

Snoring can be a symptom of obstructive sleep apnea but not everyone who snores has the sleep disorder. Obstructive sleep apnea is a serious sleep disorder that causes you to temporarily stop breathing when you are asleep. If you are regularly tired during the day even though you have had sufficient sleep or if your snoring is paired with choking or gasping sound, you may have sleep apnea. A sleep medicine physician is trained to detect and diagnose sleep apnea using an in-lab sleep study or home sleep testing. Sleep apnea is manageable using several approaches including CPAP (continuous positive airway pressure), oral appliance therapy and surgery.

Snoring - Causes and Symptoms


Causes


Obesity, Pregnancy and Genetic Factors

Extra tissue in the throat can vibrate as you breathe in air in your sleep, causing you to snore. People who are overweight, obese or pregnant often have extra bulky throat tissue. Genetic factors that can cause snoring include extra throat tissue as well as enlarged tonsils, large adenoids, long soft palate or long uvula.

Allergies, Congestion and Certain Nasal Structures

Anything that prevents you from breathing through your nose can cause you to snore. This can include congestion from a cold or flu, allergies or deformities of the nose such as a deviated septum.

Alcohol, smoking, aging and certain drugs and medications, including muscle relaxants

You may snore when your throat or tongue muscles are relaxed. Substances that can relax these muscles may cause you to snore. This includes alcohol, muscle relaxants and other medications. Normal aging and the prolonged effects of smoking can also relax your throat and tongue muscles.

Symptoms

The primary symptom of snoring is unmistakable - the often loud, harsh or hoarse noises that you make while you are asleep. Other symptoms may include waking up with a sore throat or dry mouth. 

If you have any of the following symptoms you may have sleep apnea:

  • Excessive daytime sleepiness
  • Choking or gasping while you sleep
  • Pauses in breathing
  • Morning headaches
  • Difficulty concentrating
  • Moodiness, irritability or depression
  • Frequent need to urinate during the night

Snoring - Self-Tests and Diagnosis

Does your partner complain that you snore regularly?

Have you recently gained weight or stopped exercising?

Do you have family members that snore?

If you answered yes to any of these questions you either snore or are at risk for snoring. You may want to see a sleep medicine physician if you snore regularly or loudly. If you also make choking or gasping sounds as you snore, you will need to be tested for obstructive sleep apnea.

In addition to a complete medical history, the physician will need to know how long you have been snoring. You will also need to tell the physician whether you recently gained weight or stopped exercising. Be sure to tell your physician of any past or present drug and medication use. If you can, ask your partner, roommate or family member if they have ever heard you snore.

A sleep medicine physician will recommend a home sleep apnea test, or in some cases an in-lab sleep study. A board-certified sleep physician is specially trained to diagnose sleep apnea.

In-lab overnight sleep study

This type of sleep study requires you to stay overnight at a sleep center, in a bed that may resemble a hotel room, or in some cases an actual hotel room. You will sleep with sensors hooked up to various parts of your body. These record your brain waves, heartbeat, and breathing among other things. Physicians usually recommend this test for more complicated or difficult to diagnose cases, as it is more expensive and requires you to stay overnight. Learn more about an overnight sleep study.

Home sleep apnea test

This type of sleep study lets you sleep in the comfort of your own home while a machine collects information. The testing equipment differs in that it is less complicated than what is used in an overnight sleep study. Sleep center staff will show you how to hook up the testing equipment yourself. After your home sleep apnea test, you can take the device back to the sleep center or send it by mail.

Self-help treatments for sleep apnea

While a diagnosis of sleep apnea can be scary, it is a treatable condition. In fact, there are many things you can do on your own to help, particularly for mild to moderate sleep apnea. Home remedies and lifestyle modifications can go a long way in reducing sleep apnea symptoms. However, they should not replace medical evaluation and treatment.

Lifestyle changes that can help sleep apnea

  • Lose weight. People who are overweight have extra tissue in the back of their throat, which can fall down over the airway and block the flow of air into the lungs while they sleep. Even a small amount of weight loss can open up your throat and improve sleep apnea symptoms.
  • Quit smoking. Smoking is believed to contribute to sleep apnea by increasing inflammation and fluid retention in your throat and upper airway.
  • Avoid alcohol, sleeping pills, and sedatives, especially before bedtime, because they relax the muscles in the throat and interfere with breathing.
  • Exercise regularly. As well as helping you to lose weight, starting and sticking to an exercise program can have a major effect on the duration and quality of your sleep. Aerobic and resistance training can help reduce sleep apnea symptoms, while yoga is also good for strengthening the muscles in your airways and improving breathing.
  • Avoid caffeine and heavy meals within two hours of going to bed.
  • Maintain regular sleep hours. Sticking to a steady sleep schedule will help you relax and sleep better. Apnea episodes decrease when you get plenty of sleep.

Sleep apnea treatment

If your sleep apnea is moderate to severe, or you’ve tried self-help strategies and lifestyle changes without success, it’s important to follow up with a sleep doctor who can evaluate your symptoms and help you find an effective treatment. Treatment for sleep apnea has come a long way in recent times, so take some time to explore the new options. Even if you were unhappy with sleep apnea treatment in the past, chances are you can find something that works and feels comfortable to you.
Treatments for central and complex sleep apnea usually include:

  • Treating the underlying medical condition causing the apnea, such as a heart or neuromuscular disorder
  • Using supplemental oxygen while you sleep
  • Using breathing devices that will also manage obstructive sleep apnea

Medications are only available to treat the sleepiness associated with sleep apnea, not the apnea itself, so they should only be used in conjunction with other proven sleep apnea treatments.


CPAP for sleep apnea

Continuous Positive Airflow Pressure (CPAP) is the most common treatment for moderate to severe obstructive sleep apnea. The CPAP device is a mask-like machine that covers your nose and mouth, providing a constant stream of air that keeps your breathing passages open while you sleep. Most CPAP devices are the size of a tissue box. In many cases, you’ll experience immediate symptom relief and a huge boost in your mental and physical energy.

If you’ve given up on sleep apnea machines in the past because of discomfort, you owe it to yourself to give them a second look. CPAP technology is constantly being updated and improved, and the new CPAP devices are lighter, quieter, and more comfortable. So make sure your sleep apnea device is up to date.


CPAP without the mask

One of the newest treatment options for sleep apnea is an alternative form of CPAP called Provent, a device that fits over the nostrils and is smaller and less intrusive than the traditional CPAP machine. If you haven't been able to adjust to the CPAP mask, ask your doctor about Provent. Keep in mind that Provent, however, is more expensive than regular CPAP machines, and it doesn't work for everyone.


CPAP tips and troubleshooting

Having trouble with your new sleep apnea device? It can take some time to get accustomed to sleeping while wearing a CPAP device. It’s natural to miss sleeping the “old way,” but there are things you can to do make the adjustment easier.

  • Make sure your CPAP device fits correctly. A correct fit makes a huge difference. Make sure the straps are not too tight or too loose and that the mask seals completely over your nose and mouth. Schedule regular appointments with your doctor to check the fit and evaluate your treatment progress.
  • Ease into it. Start by using your CPAP device for short periods during the day. Use the “ramp” setting to gradually increase air pressure. It’s normal to need several months to get used to sleeping this way.
  • Upgrade your CPAP device with customized options. Customize the mask, tubing and straps, to find the right fit. Ask your doctor about soft pads to reduce skin irritation, nasal pillows for nose discomfort, and chinstraps to keep your mouth closed and reduce throat irritation.
  • Use a humidifier to decrease dryness and skin irritation. Try a special face moisturizer for dry skin. Many CPAP devices now come with a built-in humidifier.
  • Try a saline nasal spray or a nasal decongestant for nasal congestion.
  • Keep your mask, tubing and headgear clean. To ensure maximum comfort and benefit, replace CPAP and humidifier filters regularly and keep the unit clean.
  • Mask the sound of the CPAP machine. If the sound of the CPAP machine bothers you, place it beneath the bed to reduce the noise. You can also try using a sound machine or white noise machine to help you sleep.

Other breathing devices for sleep apnea

In addition to CPAP, there are other adjustable airway pressure devices that a sleep specialist may recommend for sleep apnea treatment:

  • Bilevel positive airway pressure (BPAP) devices can be used for those who are unable to adapt to using CPAP, or for central sleep apnea sufferers who need assistance for a weak breathing pattern. This device automatically adjusts the pressure while you're sleeping, providing more pressure when you inhale, less when you exhale. Some BPAP devices also automatically deliver a breath if it detects you haven't taken one for a certain number of seconds.
  • Adaptive servo-ventilation (ASV) devices can be used for treating central sleep apnea as well as obstructive sleep apnea. The ASV device stores information about your normal breathing pattern and automatically uses airflow pressure to prevent pauses in your breathing while you’re asleep.


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