Snoring and Sleep Apnea

Snoring is common in adults and is not necessarily a sign of an underlying disorder.  Forty-five percent of normal adults snore at least occasionally, and 25 percent are habitual snorers.  Problem snoring is more frequent in males and overweight persons, and it usually grows worse with age.  Snoring is an indication of obstructed breathing.  An otolaryngologist can help you to determine where the encumbrance may be and offer solutions.

What causes snoring?

Snoring occurs when there is an obstruction to the free flow of air through the passages at the back of the mouth and nose.  This area is the collapsible part of the airway where the tongue and upper throat meet the soft palate and uvula.  Snoring occurs when these structures strike each other and vibrate during breathing.  Some potential causes of snoring include:

  • Poor muscle tone in the tongue and throat.  When muscles are too relaxed, the tongue falls backwards into the airway or the throat muscles draw in from the sides into the airway.  This can also happen during deep sleep.
  • Excessive bulkiness of throat tissue. Children with large tonsils and adenoids often snore.  Overweight people have bulky neck tissue.  Cysts or tumors can also cause bulk, but they are rare.
  • Long soft palate and/or uvula.  A long palate narrows the opening from the nose into the throat.  As it dangles, it acts as a noisy flutter valve during relaxed breathing.
  • Obstructed nasal airways.  A stuffy or blocked nose requires extra effort to pull air through it.  This creates an exaggerated vacuum in the throat and pulls together the floppy tissues of the throat, resulting in snoring.  Also, deformities of the nose or nasal septum, such as a deviated septum (a deformity of the wall that separates one nostril from the other) can cause such an obstruction.
  • Last month of pregnancy.
  • Use of sleeping pills, antihistamines, or alcohol at bedtime.

Why is snoring serious?

Snoring disturbs sleeping patterns and deprives the snorer of appropriate rest.  When snoring is severe, it can cause serious, long-term health problems, including obstructive sleep apnea.

Obstructive sleep apnea

When loud snoring is interrupted by frequent episodes of totally obstructed breathing, it is known as obstructive sleep apnea.  Serious episodes last more than ten seconds each and occur more than seven times per hour. Apnea patients may experience 30 to 300 such events per night.  These episodes can reduce blood oxygen levels, causing the heart to pump harder.

The immediate effect of sleep apnea is that the snorer must sleep lightly and keep his muscles tense in order to keep airflow to the lungs.  Because the snorer does not get a good rest, he may be sleepy during the day.  After many years with this disorder, elevated blood pressure and heart enlargement may occur.

What are the causes and effects of obstructive sleep apnea?

The incidence of obstructive sleep apnea increases with age and with increased weight.  It is also correlated with upper airway anatomy.  Overbite and nasal obstruction, such as that caused by allergy, may be a factor.  There is also a correlation between obstructive sleep apnea and acid reflux, diabetes, and vascular inflammation.

Is there a cure for heavy snoring?

Heavy snorers should seek medical advice to ensure that sleep apnea is not a problem.  An otolaryngologist will provide a thorough examination of the nose, mouth, throat, palate, and neck.  A sleep study in a laboratory environment may be necessary to determine how serious the snoring is and what effects it has on the snorer’s health.

What treatments are available?

Treatment depends on the diagnosis.  An examination will reveal if the snoring is caused by nasal allergy, infection, deformity, or tonsils and adenoids. Snoring or obstructive sleep apnea may respond to various treatments now offered by many otolaryngologists/head and neck surgeons.

At-home treatments

Adults who suffer from mild or occasional snoring should try the following self-help remedies:

  • Adopt a healthy and athletic lifestyle to develop good muscle tone and lose weight.
  • Avoid tranquilizers, sleeping pills, and antihistamines before bedtime.
  • Avoid alcohol for at least four hours and heavy meals or snacks for three hours before bedtime.
  • Estabish regular sleeping patterns.
  • Sleep on your side rather than your back.

For more information, visit www.entnet.org or consult with your physician.