Snoring

Symptoms Of Snoring

Symptoms associated with snoring include:

• Raspy sounds produced in the throat or nose during sleep may range from quiet vibrations to whistling, snorting, or rumbling. 

• Restless sleep

• Waking up frequently at night feeling confused

• Breathing pauses

• Chest pain at night

• Waking in the morning not feeling rested

• Dry and sore throat upon awakening

• Morning headaches

• Excessive daytime sleepiness

• Mood swings and irritability

• Reduced levels of concentration

• Impacted memory

Causes Of Snoring

While breathing, air flows in and out through the nose or mouth and throat. There are relatively few sounds when we are sitting and breathing quietly. 

While sleeping, there is a narrowing of the area at the back of the throat. The same amount of air passing through this smaller opening can increase the speed of air and cause the following tissues that surround the opening to vibrate:

• Soft palate (the back of the roof of your mouth)

• Tonsils

• Adenoids

• Tongue
  
  

This can cause the sounds of snoring. People who snore may have different reasons for the narrowing, discussed in detail in the next section.

Risk Factors for Snoring

1. Advancing age

Snoring becomes more common with age due to decreased muscle tone, causing airways to constrict. Research demonstrates that individuals above 40 years of age are at a higher risk.

2. Gender 

Males have narrower air passages than females and hence are more likely to snore. 

3. Family history

Individuals with a family history of snoring are more likely to snore.

4. Nasal and sinus problems

The following conditions can cause obstruction of airways and increase the risk of snoring:

• Nasal congestion 

• Sinusitis

• Deviated nasal septum 

• Nasal polyps
  
  

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5. Structure of the mouth, jaws and throat

Some of the structural changes associated with snoring include:

• A smaller or backward-placed jaw

• A larger tongue

• A long soft palate or a long uvula

• A cleft palate

• A narrow throat

• Enlarged tonsils

6. Obesity

Excess amount of fat around the face, and neck region, and poor muscle tone can predispose to snoring.

7. Sleep posture

Sleeping flat on your back can cause the muscle of the throat to relax and block the airway leading to snoring. 

8. Sleep deprivation

In case of lack of sleep, the throat muscles tend to relax too much, predisposing to snoring.

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9. Alcohol 

Alcohol consumption relaxes the throat muscles, increasing the risk of snoring.

10. Smoking

Smoking can cause upper airway inflammation and edema, increasing the likelihood of snoring.

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11. Certain Medications

Certain medicines like lorazepam and diazepam have the potential to relax throat muscles and restrict the airway which can lead to snoring.

12. Later phase of Pregnancy

Hormonal changes, weight gain, and an increase in blood flow, during pregnancy may increase the risk of snoring. Snoring often worsens as the pregnancy progresses, peaking in the third trimester.

13. Menopause

Hormonal changes, weight gain, and age-related loss of muscle tone in the throat area, associated with menopause can increase the likelihood of snoring, or worsen pre-existing snoring problems.

Diagnosis Of Snoring

Snoring is easily diagnosable. However, your doctor may advise a few tests, along with a detailed history and examination, to arrive at the cause of snoring.

1. Medical history

The doctor might inquire about your

• Snoring habits

• History of any medications or medical issues

• Experience of reduced concentration, daytime sleepiness or any other associated symptoms.

May also ask your partner a few questions about your sleep pattern as well as when and how you snore.

2. Physical examination

Your doctor can perform a physical exam to determine if your snoring is caused by any issues in your nose, mouth or upper airways.

3. Imaging tests

These tests help to check the structure of your airway for abnormalities, such as a deviated septum, or any other airway obstruction:

• X-rays

• Magnetic resonance imaging (MRI)

• Computerized tomography (CT)

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4. Other tests

Drug-induced sleep endoscopy (DISE)
It is a medical procedure used to diagnose sleep disorders related to breathing difficulties. It allows doctors to observe the upper respiratory tract of a patient while they are in a sleep-like state.

Polysomnography (sleep study)

This consists of an in-depth analysis of your breathing during sleep by a study. During this process, the following information is recorded:

• Brain waves

• Blood oxygen level

• Heart rate

• Breathing rate

• Sleep stages

• Eye and leg movements

Specialist To Visit

If you have been experiencing any signs and symptoms of snoring for an extended period, then it’s time to make an appointment with your doctor. The doctors that can help you include:

• Otolaryngologist 

• Internal medicine specialist

• Allergist or Immunologist

• Head and neck surgeon (in case of any surgery)
  
  

An otolaryngologist, also known as an ENT specialist, is a doctor who specializes in treating and diagnosing disorders related to the ear, throat, and nose.

Internal medicine specialists focus on identifying, preventing, and treating diseases that affect multiple systems in the body.

An immunologist or an allergist specializes in diagnosing, treating, and preventing immune system disorders.

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Prevention Of Snoring

1. Maintain a healthy weight

Obese people are more prone to snoring and weight loss in such individuals can reduce both snoring and obstructive sleep apnea symptoms.

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2. Quit smoking

Smoking causes inflammation in the airway which can lead to obstructed breathing and decreased airflow, resulting in snoring.

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3. Avoid alcohol before bedtime

Intake of alcohol, especially at bedtime can relax your throat muscles way too much and predispose to snoring.

4. Be mindful of using sedative medications

Sedatives are a potential risk factor for snoring. Hence, avoid consuming sedatives like zolpidem, clonazepam, and eszopiclone before going to sleep.

5. Treat any ongoing nasal congestion

Your chances of snoring are higher if your nose is stuffy due to nasal congestion due to a cold or allergy. Treat any ongoing nasal congestion after consulting with your doctor.

6. Follow these simple and effective tips

• Stick to a proper sleep schedule every night

• Try to sleep on your side and not on your back.

• Elevate the head of your bed by a few inches.

• Do not eat right before bedtime.
  
  

Chronic lack of sleep can cause serious and irreversible health ailments. Here are a few simple and effective habits that you can adopt to ensure that you get a sound sleep.
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Treatment Of Snoring

Treatment is based on the cause, severity, and duration of snoring. Depending upon your medical history and present condition, your doctor will suggest suitable treatment options. They may include:

1. Lifestyle modifications

Healthy lifestyle changes may improve your health and ease your snoring to a great extent. They include:

• Undergoing a weight loss program

• Limiting alcohol

• Practicing throat exercises

• Not sleeping on your back

• Using a breathing assistance device
  
  

2. Medications

• Anti-allergics: Treating allergic nasal inflammation can successfully reduce snoring and decrease other symptoms related to poor-quality sleep. Common anti-allergic medicines used to treat nasal allergies include:

  • Cetirizine

  • Clemastine

  • Chlorpheniramine 

• Decongestants:  Examples of decongestants used to remove stuffy noses include:

  • Naphazoline

  • Oxymetazoline

  • Phenylephrine

  • Adrenaline

  • Oxymetazoline+Sorbitol

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3. Oral appliances

Custom-fitted oral appliances or dental mouthpieces can help to advance the position of your jaw, tongue, and soft palate to keep your air passage open. 

If you choose to use an oral appliance then dental visits are important at least once every six months to have the fit checked and to assess your oral health. 

4. Continuous positive airway pressure (CPAP)device

CPAP is a device that is often used to treat snoring especially when associated with sleep apnea. A CPAP device includes wearing a mask over your nose or mouth while you sleep. It delivers enough air pressure to a mask to keep your upper airway passages open, preventing snoring. 

5. Upper airway surgeries

Various procedures are available to open the upper airway. These include:

• Uvulopalatopharyngoplasty (UPPP): Excess throat tissue is tightened and shortened under general anesthesia.

• Maxillomandibular advancement (MMA): It involves moving the upper and lower jaws forward to widen the airway. 

• Radiofrequency ablation (or somnoplasty): This procedure uses radiofrequency to shrink excess tissue in the soft palate and tongue.

• Tonsillectomy and adenoidectomy: These involve removing excess tissue from the back of the throat or nose.

Home-Care For Snoring

You can try these solutions to reduce snoring and get a good night’s sleep:

• Apply nasal strips(without medicine) to the bridge of your nose to allow more air into the nostrils.

• Invest in a snore-reducing pillow that keeps your head in the proper position when you sleep.

Snoring is very commonly associated with nasal blockages caused due to cold or allergic conditions. To alleviate these, you can try simple and effective home remedies like:

• Eucalyptus (Neelgiri) oil: Studies have shown that eucalyptus oil reduces allergic reactions and can provide instant relief from a stuffy nose.

Put a few drops of eucalyptus oil in your steamer and inhale them for a few minutes to ease your nasal congestion.

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• Carom (Ajwain): Ajwain oil is known to suppress sneezing and nasal discharge. 

Adding a pinch of ajwain seeds to a bowl of hot boiling water and inhaling its steam can reduce your nasal congestion. 

• Basil (Tulsi): Tulsi or holy basil has a range of health benefits. Consuming a few raw tulsi leaves and honey on an empty stomach can boost immunity and fight conditions like sinus infections, and the common cold.
  
  

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• Turmeric (Haldi): Turmeric is a potent anti-inflammatory, antibiotic and antioxidant agent. 

Chewing a raw turmeric root on an empty stomach or just drinking turmeric milk can help manage nasal congestion.

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• Garlic (Lehsun): It is one of the most powerful natural antibiotics and helps relieve nasal congestion when the cause is an infection or allergy. You can consume a raw garlic clove on an empty stomach every day to see the benefits.

Complications Of Snoring

Most cases of snoring do not pose any complications and resolve with proper treatment. However, some cases can be associated with the following complications:

1. Sleep apnea: Snoring is often linked with sleep apnea, a disorder in which your upper airway gets blocked many times while you are asleep, reducing or completely stopping the airflow.

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2. Headache: When you don’t sleep properly at night, you may develop a headache which hampers your daily activity and productivity.

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3. Nocturia: Research shows that individuals who snore may produce more urine. Nocturia is the habit of getting up at night repeatedly to urinate.

4. Irregular heartbeat and Cardiac diseases: Research has proved that those with snoring and sleep apnea are at a greater risk of having an irregular pattern of heartbeat and other cardiac problems.

5. GERD or gastroesophageal reflux disorder: Acid reflux can occur due to unstable breathing during sleep apnea, as a pressure change brings the stomach content up to the food pipe.

6. Mental health issues: Snoring affects your overall mental health. Spending sleepless nights increases the chances of anxiety and depression.

7. Stroke: Snoring loudly can be a sign of obstructive sleep apnea that can increase the risk of stroke.

8. Fetal complications: If a woman is pregnant and she snores, it may pose a health risk to the mother as well as the baby. When the mother’s body doesn’t get enough rest during pregnancy, that can affect the health of the fetus within the womb.

Alternative Therapies for Snoring

The basic aim of alternative therapies is to alleviate snoring and act as an adjunct to general treatment. 

1. Yoga

Practicing yoga can strengthen your lungs and nasal passages over a period of time. Yoga asanas such as Pranayama, Bhramari Pranayama, Kapalbhati, Bhujangasana, and Dhanurasana can help with snoring and can enable better blood circulation to your lungs, throat, and nose.

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2. Acupuncture

Research suggests that acupuncture may be effective at reducing snoring. However, more studies are needed to validate the same. Make sure to talk to your healthcare provider before starting acupuncture.

Living With Snoring

Snoring can be a sore subject for your partners, roommates, and family members. It can cause disrupted sleep not just for you, but for your loved ones as well. Living with snoring is learning the right ways to prevent the condition from aggravating and relieving the symptoms. Here are a few tips that might help:

Change your sleeping position

Sleeping on your side allows air to flow easily and can reduce or stop your snoring. This is because while sleeping on your back, your tongue moves to the back of your throat, thus blocking airflow.

Follow sleep hygiene

If you don't sleep enough, you might start snoring because your throat muscles become relaxed and can block your airways. 

Sleep for at least 7 hours, and to achieve that follow a sleep routine by sleeping and waking up at the same time every day. This helps a great deal in falling asleep faster and improving the overall quality of sleep.

Use head-elevating aids

Using products such as pillows or bed risers for elevating the head of your bed helps reduce snoring since it keeps the airways open.

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Try nasal strips or nasal dilators

The internal nasal dilator should be applied to the nose at bedtime, whereas the nasal strip should be applied on the bridge of the nose at bedtime too. Both should be worn the whole night. They have shown good results in reducing snoring.

Try mouth exercises

You may consider oropharyngeal exercises (mouth exercises) to stop snoring. They’ve been found to effectively reduce snoring. Talk to your doctor to understand how they are done.

Tips to manage snoring partners

To manage a partner’s snoring and get some more sleep, it is important to be patient and find a solution. Also, learning to cope with the problem can take you a long way. Try these:

• Let them know they snore

• Help them make diet and lifestyle changes

• Sleep back-to-back to prevent your partner from rolling onto their back

• Understand their snoring triggers

• Go to bed before your partner

• Use earplugs

• Get a white noise machine.