Snoring is a loud sound as you sleep. Snoring happens when the flow of air makes the tissues in your throat vibrate. While exhaling during one’s sleep, the air comes out through the nose, mouth, or a combination of the two, which can cause snoring. Snoring can happen at any stage of the sleep cycle. 

Almost about half of the people snore at some of the other points in their lives. Men are more prone to snoring than women. According to statistics, around 40 per cent of men and 24 per cent of women are regular snorers. Men tend to snore less after the age of 70.

People who sleep on their backs are more prone to snoring. Congestion from cold can also cause you to snore. 

Snoring can be a problem for your partner or anyone who sleeps next to you. Dry mouth and irritated throat are due to snoring.

Types

There are different types of snoring they are :

Nasal snoring


Nasal snoring is the result of blocked nostrils. Block nostrils happen because of allergies, cold or flu, deviated septum, medications or smoking. If you recurrently have a stuffy nose at night, it is essential to know why it is happening. The cause is determined to take the necessary precautions or treatment like quitting smoking, allergy medications, using nasal strips, or getting a surgical solution.

Snoring in the mouth


Mouth snoring happens when You breathe through your mouth rather than your nose during sleep. Snoring can occur due to tonsillitis, stuffy nose or weak palatal tissue. Your body breathes through the mouth when you cannot breathe through your nose to resolve this problem; you can take treatment like removing tonsils that can get you to stop snoring.

Snoring based on the tongue


When your tongue becomes too relaxed during sleep, it leads to tongue-based snoring. The relaxed tongue causes blockage in the airway passage; this occurs due to excessive alcohol drinking, people who have excessive neck fat, using sleeping pills etc.

Snoring throat


This is the loudest type of snoring. Throat snoring is a strong indicator of Sleep apnoea. Sleep apnoea occurs as a result of airway obstruction. Due to this, your body begins to cough to open your airways and facilitate breathing. As an outcome of this, it is difficult to get a good night’s sleep, and you will snore.

Symptoms

Snoring makes a vibrating, rattling and loud sound while breathing when you are asleep. Other symptoms you may face if you snore often are:


  • Excessive daytime sleep

  • Headaches in the morning

  • Weight gain

  • Not feeling fresh after waking up in the morning

  • Feeling confused after sudden awakening at night

  • Decreased levels of attention and concentration

  • Nighttime awakenings due to air hunger or hypoxia during sleep.

Causes And Risk Factors

Causes


Snoring is a consequence of the vibration of tissues. When you are asleep, the muscles at the back of the throat loosen up and narrow up the airway. As you inhale or exhale, the air that moves causes the tissue to vibrate, making you snore.

Some people tend to snore because of the size and shape of the muscles and tissues in their neck, while, as in others, it can happen due to the narrowing of the airways.

Risk Factors


Risk factors that contribute to a greater risk of snoring are:

  • Obesity

  • Alcohol consumption

  • Having a stuffy nose for a long time

  • Large tonsils, tongue or soft palate

  • Deviation of septum

  • Small or set back jaw

  • Pregnancy

Prevention

A few changes before bedtime can help you to reduce snoring. You should try:


  • Using nasal strips prior to bedtime will allow the passage of air freely into the nostrils.

  • Avoiding alcohol.

  • Do not smoke.

  • Maintain a workout routine that will keep you healthy and watch your weight.

  • Sleep on the side rather than the back.

Diagnosis

A thorough ear nose and throat examination is conducted to check for abnormalities in the oral and nasal passages causing snoring. Sometimes, this is the factor based on which physician can determine the cause of snoring and give treatment. The physician also conducts a detailed medical history interview which can help him to know your situation better.

1. Imaging tests: X- Rays, MRI or CT scans are recommended to check for any problems in your airway.

2. Sleep study: In a sleep study, machine monitoring of your sleep is done preferably at your home or in the lab; this test is called a polysomnogram. In this test, factors like pulse rate, breathing, blood oxygen saturation and brain functions are evaluated as you sleep. In this overnight test, there are sensors attached to your head and other parts of the body that record:


  • Heart rate

  • Respiratory rate

  • Oxygen levels in the blood

  • Movement of legs

  • Brain waves

  • Sleep stages


3. DISE Sleep endoscopy, also known as sleep nasendoscopy (SNE) or drug-induced sleep endoscopy (DISE), is a powerful tool for studying the dynamic airway in a sleeping patient with obstructive sleep apnoea (OSA).

Treatment

Medical treatment for snoring is beneficial. Newer devices and advances are in constant development and are becoming more and more comfortable and practical. The physician may recommend medical devices or surgical procedures like:


  • Continuous Positive Airway Pressure (CPAP): A machine at the bedside blows pressured air into the mask that is supposed to be worn over your nose and face.

  • Laser-assisted uvulopalatoplasty (LAUP): laser is used to scrape off the uvula making minor cuts in the soft palate. As the healing process begins, the surrounding tissue stiffens, which prevents snoring.

  • Palatial implants: Also known as the pillar procedure. In this procedure, small planting implants fit in the soft palate, which prevents the collapse of the palate that causes snoring.

  • Somnoplasty: Low levels of radiofrequency are used to remove tissues from the uvula and soft palate. This procedure takes around 30 mins.

  • Custom-fitted dental devices and lower jaw- positioners: A dentist will guide you through this procedure. Devices help to bring the lower jaw and tongue forward during sleep.

  • Surgical procedure: Surgical procedures help by correcting abnormalities and widening the airway. Commonly recommended procedures are tonsillectomy, adenoidectomy etc.

Lifestyle/management

Lifestyle changes that can benefit you are:


  1. Losing weight: Even a little bit of weight loss can cause a reduction in fatty tissues behind the throat, which can help you stop snoring.

  2. Quit smoking: Smoking is known to irritate membranes of the nose and throat, which causes blockage in the airways resulting in snoring.

  3. Avoiding alcohol, sleeping pills and sedatives: Intake of alcohol, sleeping pills, and sedatives cause excess relaxation of muscles in the throat and interfere with breathing.

  4. Be careful about what you eat before bed: Eating dairy or soy products can worsen snoring.

  5. Exercise: Exercising has been found to be effective in reducing snoring. Exercise can help you to tone the muscles of your throat.

  6. Clear nasal passages before sleeping: Try to decongest the stuffy nose by using nasal decongestants before going to sleep.

  7. Use humidifiers.

Prognosis And Complications

Prognosis


A healthy lifestyle might help you to prevent the symptoms and improve sleep. Regular monitoring by the physicians is necessary to make sure the treatment you are currently taking is right.
Sleep is necessary to keep your body healthy and revitalized; without proper sleep, your physical and mental well-being is at risk. Simple lifestyle changes can help you to improve the quality of your life and your partner’s life as well.

Complications


Snoring, if not treated when necessary, can cause complications like:

  1. Direct Blood Oxygen Levels: The normal level of blood oxygen is between 94% and 98%. Obstructive sleep apnoea for more than 30 seconds can lower it to 80% or less.

  2. Heart disease: Heavy snorers are more prone to cardiovascular problems like high BP. Such people are at a greater risk of developing heart diseases or heart attacks. An irregular heartbeat is another complication of snoring.

  3. Strokes: The intensity of snoring affects the arteries in your neck because of the fat deposits in them, which increases the chances of having a stroke.

  4. Accidents: Snoring causes a lack of concentration and can make you feel sleepy Throughout the day leading to accidents.

  5. Mental health concerns: Lack of sleep due to snoring causes anxiety and depression, leading to deterioration in mental health.


References. 



  1. Sleep Education. Snoring – Overview and Facts. [Internet] Available at:  https://sleepeducation.org/essentials-in-sleep/snoring/overview-and-facts 

  2. Medicover Hospitals. How to stop snoring naturally. [Internet] [Updated on: 21/01/2021] https://www.medicoverhospitals.in/how-to-stop-snoring-naturally/ 

  3. Hopkins Medicine. Snoring. [Internet] Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/snoring 

  4. Sleep Foundation. Snoring. [Internet] [Updated on: 21/08/2021] Available at: https://www.sleepfoundation.org/snoring 

  5. Help Guide. Snoring Tips to Help you and your partner sleep better. [Internet] [Updated on: 1/08/2020] Available at: https://www.helpguide.org/articles/sleep/snoring-tips-to-help-you-and-your-partner-sleep-better.htm 

  6.  Pennmedicine. Is your snoring sleep apnoea? [Internet] [Updated on: 03/12/2019] Available at: https://www.pennmedicine.org/updates/blogs/health-and-wellness/2019/december/is-your-snoring-really-sleep-apnea 



  1. American Sleep Association. Signs of sleep apnea [Internet] Available at: https://www.sleeprenewal.co.za/oxygen-levels 

  2. Veer V, Zhang H, Beyers J, Vanderveken O, Kotecha B. The use of drug-induced sleep endoscopy in England and Belgium. Eur Arch Otorhinolaryngol. 2018; 275(5): 1335–1342.

  3. Sleep Renewal. Oxygen levels can affect your sleep [Internet] Available at: https://www.sleeprenewal.co.za/oxygen-levels

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