Snoring

This side sleeping position may be good for those who snore.

Snoring is a sound that occurs when sleeping as airflow causes the tissues in the back of the throat to vibrate. The sound of snoring usually occurs as you inhale, and it can happen at any time while you sleep. Half the population snores at some point, though snoring is more common in men than women, it can run in families, and it happens more frequently as we age.

There are several causes for snoring, which include:

• Being overweight or obese
• Pregnancy
• Allergies
• Asthma
• Congestion from colds or the flu
• Nasal deformities (such as a deviated septum or nasal polyps)
• Enlarged tonsils or adenoids
• A long soft palate or long uvula
• Drinking alcohol
• Muscle relaxants and other drugs
• Smoking
• Aging
• Sleep position (usually sleeping on your back)

Snoring can be a symptom of common conditions such as allergies or asthma. But it also can be a symptom of a serious medical condition called obstructive sleep apnea in which a person stops breathing intermittently during sleep. A person with sleep apnea may snore loudly or make choking noises as they try to breathe. The body becomes deprived of oxygen, and a person may wake up from it. When severe, this can happen hundreds of times during the night or when sleeping at other times during the day.

Sleep apnea is associated with a higher risk for the following:

• high blood pressure,
• heart disease,
• stroke,
• obesity, and
• type 2 diabetes.

If you're living with someone who snores, the first step is making sure they know they snore (if they are not awakened by their snoring they may not be aware of it). Next, encourage them to visit a doctor to diagnose and treat the underlying cause. You also can help your partner track their snoring habits if the doctor needs a sleep journal. They may try some of the home remedies mentioned previously to stop snoring.

In the meantime, sharing a bed with someone who snores can be exhausting. To take care of yourself, try the following:

• Use earplugs
• Try a white noise machine
• Try going to bed before your partner – if you're already asleep maybe you won't hear them
• Consider sleeping in separate bedrooms. This is often a last resort and a personal decision for partners.

Many kinds of doctors treat snoring, depending on the underlying cause. You may first consult your primary care provider (PCP) such as a family practitioner or internist, or a child's pediatrician.

For further testing and management of snoring or sleep disorders such as sleep apnea, you may be referred to a sleep medicine specialist.

Allergies may be treated by an allergist, and asthma may be treated by a lung specialist (pulmonologist) or respiratory therapist. If you have nasal deformities such as a deviated septum or nasal polyps you may see an ear, nose, and throat specialist (ENT, or otolaryngologist), and if you require removal of your tonsils or adenoids you may be referred to a general surgeon.

Sometimes an oral appliance is helpful to help stop the snoring. This may be fitted by a dentist.

The diagnosis of the underlying cause of snoring will depend on the symptoms and the suspected reason for the snoring. The doctor will start by asking about allergies, medications, and whether you drink alcohol or smoke. The mouth, nose, and throat will be examined to see if there are any physical deformities that may be the cause of the snoring.

If sleep apnea is suspected, you may be asked about whether you wake up gasping for breath, if you fall asleep during the day, if your partner notices you snore loudly or stop breathing while you sleep, and if your sleep is not refreshing. You may need to keep a diary of your sleep habits and snoring.

A sleep study may be necessary to monitor your sleep patterns and diagnose whether you have sleep apnea or any other sleep disorder.

Once you have ruled out sleep apnea as the cause of your snoring, the next step is figuring out how to stop snoring.

There are some home remedies and behavior changes that may help reduce or eliminate snoring:

1. Lose weight.
2. Don't sleep on your back.
3. Avoid alcohol.
4. Don't take muscle relaxants (talk to your doctor before stopping any prescription medication, and ask about alternatives).
5. Quit smoking.
6. Try an anti-snoring pillow.
7. Use nasal strips to open nasal passages.
8. Take a hot shower before bed to open the sinuses.
9. Change sheets frequently if allergies cause snoring (vacuum and dust regularly too.)
10. Use a humidifier or vaporizer.
11. Throat exercises
12. Cognitive Behavioral Therapy (CBT)
13. Anti-snoring apps: For those who love technology, there are several anti-snoring apps available. Download these anti-snoring solutions them onto your phone or tablet, to figure out ways to stop snoring. These apps can help record your snoring, analyze your sleep, and even play a sound to awaken you when they detect a snore.

CPAP (Continuous Positive Airway Pressure)

When snoring is caused by obstructive sleep apnea, a CPAP (Continuous Positive Airway Pressure) is often prescribed. This machine uses air pressure to keep the airways open while you sleep so you do not stop breathing, and it is an effective non-surgical treatment for sleep apnea.

There are a few variations of CPAP devices:

• Nasal CPAP mask: This covers the nose only and is the most common type of CPAP. This type works best for those who breathe from their nose and they can operate with higher air pressure settings. It is not good for mouth breathers or those who have allergies or sinus issues.
• Nasal pillow: These are small prongs that insert directly into the nostrils. It is smaller and may be more comfortable for some people. It's also good for those with a lot of facial hair who cannot get a good seal on a standard CPAP mask, or for those who feel claustrophobic with a mask covering their face. They may cause nasal dryness and nosebleeds, or pressure ulcers in the nostrils, and can be less comfortable with higher-pressure airflow.
• Full-face CPAP mask: This covers the entire nose and mouth and has side straps to keep the mask in place. It works best for those who require high-pressure air flow and prevents air leakage for those who sleep on their backs. It is not optimal for stomach sleepers and can be difficult to wear glasses, watch TV, or read while wearing them.

Anti-snoring devices

An anti-snoring mouthpiece may be a viable treatment for snoring. Many people snore because airflow, as you breathe, causes the tissues in the back of your throat to vibrate. Anti-snoring aids such as mouthpieces (also called mouth guards or night guards) help bring the jaw forward to widen the back of the airway, allowing air to pass through without resistance, stopping snoring. Sometimes, these mouthpieces can stop snoring immediately, the first time they are used.

There are two main types of anti-snoring mouthpieces:

1. Tongue Stabilizing Devices (TSD) work by sucking the tongue forward or downward, increasing the opening at the back of the throat, and helping to decrease the amount of tissue that can vibrate. Some people find them uncomfortable and they may cause increased salivation.
2. Mandibular Advancing Devices (MAD), also called Jaw Advancing Devices (JAD) work by moving the lower jaw forward to open up the back of your throat and let air pass through more freely. They also move the tongue forward. They may cause some discomfort or shifting of your teeth.

A chinstrap will not help reduce snoring. A study by the American Academy of Sleep Medicine found that a chinstrap does not improve sleep-disordered breathing and is ineffective in improving snoring.

It's important to avoid foods that may trigger or increase snoring. For example, if you have food allergies, avoid these foods as they may cause inflammation in your mouth and throat, restricting the airway and leading to snoring. Alcohol is a relaxant, and it relaxes the muscles in the back of the throat, which can increase the blockage of the throat and make it harder for air to pass through.

Foods you might try to help reduce snoring include:

• Non-dairy milk: Dairy can cause some people to have increased mucus, so plant-based milk will help avoid this problem (for example almond or soy milk).
• Hot tea: If you have a cold or sinus congestion that causes your to snore, hot beverages such as tea (with a little honey) can be soothing.
• Turmeric: This spice is known for its anti-inflammatory properties.
• Fruit and vegetables: These are full of antioxidants and fiber, and can help you lose weight.
• Peppermint: Stick with the oil (not the candy) for anti-inflammatory benefits.
• Horseradish: It can help dry excess mucus.
• Water: Stay hydrated.

Medical treatments for snoring include assistive breathing devices such as the CPAP. Sometimes, surgery may be required. If snoring is due to a deviated septum, nasal polyps, or other nasal deformities, surgery can correct these problems. Surgery also can reduce bulky tissue in the throat or alter the bone structure to reduce or cure your snoring.

Types of surgery that may be performed to cure causes of snoring include:

• Tonsillectomy and/or adenoidectomy to remove enlarged tonsils and/or adenoids
• Uvulopalatopharyngoplasty (UPPP) which thins and tightens the tissue in the throat
• Thermal ablation palatoplasty (TAP) uses radio waves to shrink throat tissues
• Laser-assisted uvulopalatoplasty (LAUP) uses a laser to shorten the uvula
• Palatal implants (also called the Pillar procedure) involve the insertion of implants into the soft palate to help stiffen the soft tissue and reduce vibration
• Somnoplasty uses radiofrequency heat energy to remove or stiffen tissues of the uvula and soft palate so they don't vibrate

Snoring can be prevented by preventing the underlying cause, such as:

• If you are overweight, lose weight.
• If you have allergies, change sheets frequently and keep your bedroom vacuumed and dusted, and take doctor-recommended allergy treatments.
• Don't smoke.
• Avoid alcohol.
• Don't take muscle relaxants or medications that make you snore. Ask your doctor for alternatives. Never stop taking prescribed medication without talking to your doctor first.
• Sleep on your side.