Chronic Snoring

Snoring can be an irritation to the snorer and to others in the house who have to hear him or her. It can also be a potentially serious problem requiring medical attention. There are several treatment options, including general health measures such as improved muscle tone through exercise, weight control, and concurrent medical problems. Doctors then have other options. They consider severity of snoring, individual preference, and individual anatomy in choosing a therapy. Snoring is not the same as apnea, although they can be confused for each other.

People of all ages, types, and kinds snore, although it is more common in men than women and more common in heavier people. About 40 million Americans, 40% of men and 30% of women, and their bed partners suffer from chronic snoring, with up to half of those having sleep apnea (see next section). Chronic snoring is associated with an increased incidence of heart and brain-related diseases. The U.S. Patent and Trademark Office lists more than 300 anti-snoring devices which try to do one or more of the following:

• Keep the snorer off his or her back;
• Keep the mouth closed and prevent the tongue from falling backward;
• Keep the neck lengthened; and
• Startle the snorer awake with a shock or other stimulus.

However, before turning to such remedies, a snorer should consult a doctor to make sure that he or she does not suffer from sleep apnea.

People of all ages, types, and kinds snore, although it is more common in men than women and more common in heavier people.

A large soft palate or uvula contributes to the probability of snoring, which is part of the reason overweight people snore more. Drinking alcohol (or consuming another sedative) can contribute to snoring. It makes your muscles relax, including the your mouth and throat muscles. That’s why some people snore more when they are drunk, and loud snoring is a hallmark of someone who has passed out drunk.

Anatomical configurations of the mouth and nasal passages can cause snoring.

Do fat people always snore?

No, not always. Different people have different anatomies, different sleep positions, different configurations of their uvulas, different muscle tones. However, both anecdotal evidence and more formal studies show a correlation between snoring and obesity.

"Laugh and the world laughs with you. Snore and you sleep alone." - Anthony Burgess

Snoring Therapies

If you have ever slept next to someone that snores, you understand the importance of snoring treatments. Not only does it have the potential for developing into more serious sleep conditions for the snorer, but it affects other’s sleep environment resulting in their sleep loss. Fortunately, there are many options for treatment, so the biggest challenge may be convincing the person who snores that they need intervention. From positional therapies, to manipulative devices, and to even surgeries, there are several considerations that can be explored.

In short, snoring occurs as the result of a narrowing of the upper airway. When one falls asleep, the soft tissue and muscles of the throat relax, and the diameter of the airway is reduced. If the diameter was already compromised, this reduction can result in snoring just like air flowing through a whistle. The most common site of obstruction is where the back of the tongue comes in contact with the throat. In addition, snoring is more likely with narrowing of the nasal airways. If the nasal passages are compromised, the lungs must inhale with greater force to achieve the same amount of airflow into the body. This increased force can result in collapse of the upper throat area as well causing snoring. Snoring alone, however, does not affect the snoring individual’s sleep, but it can be a sign of more significant conditions like sleep apnea syndromes.

Because of gravity, the tongue causes the biggest problem when one is lying on their back, or supine. The tongue falls back into the throat area, and snoring ensures. As a result, some people respond well simply by avoiding this position. While using pillows to tilt the body off its back is an option, special wedge pillows can accomplish this more effectively. In addition, special pajamas are available that promote sleep on one’s side. For instance, some have a tennis ball sown in the area that fits between the shoulder blades so that the discomfort of this while on your back stimulates you to move onto your side even while sleeping.

Other therapies focus on the nasal passages and airways. Nasal strips that are placed externally on the nose bridge flatten the nose and enhance nasal airflow by increasing the opening of the nostrils and adjacent nasal passages. If the obstruction is mild, these strips can be beneficial. Decongestants are other options if nasal congestion is causing inflammation and swelling that hinders normal airflow through the nose. In addition, surgical treatment can address nasal conditions such as a deviated septum that likewise may be limiting airflow. Any of these can result in “mouth-breathing” at night, and as the jaw opens, the mechanics of the throat and jaw can further compromise the airway diameter.

Other devices are considered mechanical. The most commonly used devices currently are CPAP, or continuous positive airway pressure, devices. These are usually used when sleep apnea syndromes are also present. Sleep apnea syndromes simply represent a spectrum of conditions in which the same airway obstruction that cause snoring worsens to the point that arousals occur and sleep for the patient is disrupted. CPAP devices are machines that generate air pressure through a mask on the nose and mouth to form an air splint in the throat while asleep. The pressure keeps the airway from collapsing thus preventing snoring. Various masks are now available which can help individualize this treatment a great deal. Other mechanical devices also include oral appliances. These are specially formed and fitted dental mouth pieces that can pull the tongue forward, advance the lower jaw, or both. Again the effect results from opening the diameter of the airway in the throat area reducing or preventing snoring. While some of these are available without medical guidance, many dentists specialize in tailoring these devices for patients affected by snoring.

Lastly, there are surgical options geared at correcting the anatomy that is causing the snoring itself. Otolaryngologists - ear, nose, and throat doctors - are the specialists who often get involved. In additional to nasal surgery, techniques that target the throat or pharynx are employed. Standard surgeries like uvulopalatopharyngoplasty (UPPP) remove the uvula hanging from the roof of the soft palate along with some of the soft palatal tissue to expand the opening of the throat. Similar surgeries that are easier to perform also now include Laser Assisted Uvulopalatoplasty (LAUP) and also Somnoplasty. Somnoplasty, along with another surgical technique called coblation-channeling, uses radiofrequency energy to damage tissues in the same area that then shrinks allowing expansion of the airway as well. Another option can also be the injection of sclerosing agents into the soft palate. These agents cause the tissues of the pharynx to scar, and as the scar evolves, the tissues also shrink. While all of these measures have a fair amount of success in snoring, the relapse occurrence of snoring years later is relatively high with all of these techniques.

Alcohol and Sleep

Sleep and obesity

Sleep Disorders

Dyssomnias

Parsomnias