Any noisy or disrupted breathing during sleep is snoring. It is a very common problem and can occur at any age or time in our lives. It is strongly associated with sleep apnea but can occur on its own as well. Even snoring by itself without sleep apnea can have a direct impact on our quality of sleep and health. Patients with snoring problems often are encouraged to seek treatment by their spouse, significant others or roommates. It is a source of great stress and friction for many relationships.
SYMPTOMS: Loud breathing sounds during sleep, gasping or choking at night, restless sleep, fatigue, daytime sleepiness, pauses in breathing while sleeping, memory loss, trouble concentrating, mood swings, depression, dry mouth, sore throat, headaches, nasal congestion and blockage, weight gain, disrupting other people’s sleep and relationship problems due to the snoring.
DIAGNOSIS: A thorough medical history and physical exam are the first step in diagnosing snoring. The nasal airway can be checked for blockage with Nasal Endoscopy and the upper / lower airway can be examined with Flexible Laryngoscopy. Next a sleep quality survey like the Epworth Sleepiness Scale is taken to further evaluate for the presence of sleep apnea (as snoring is very strongly associated with sleep apnea). If the exam and survey indicate a likelihood of snoring with sleep apnea, then a sleep study is done next. This can be done in a sleep lab (PSG – polysomnography) or at home with a Home Sleep Study.
CAUSES: Snoring is the sound that occurs when the soft tissues in the back of mouth / throat vibrate due to turbulent airflow hitting the soft palate. Drinking alcohol before sleep or having a cold / nasal congestion will make snoring more notable. Causes of snoring include redundant or loose soft palate, large uvula, deviated nasal septum, turbinate hypertrophy, nasal congestion, allergies, sinus problems, jaw and oral cavity anatomical problems, large tongue, relaxation of the throat muscles while sleeping, being overweight or weight gain, sleeping on your back and alcohol consumption.
TREATMENT: Snoring should be treated as seriously as sleep apnea. While snoring without sleep apnea has less severe medical consequences than if sleep apnea is present, it still has a direct and negative impact on our health and wellbeing. Increasingly sleep research is showing that snoring has a direct and negative impact on the quality of our sleep causing decreased REM and deep sleep – both of which are vital to getting healthy sleep. Treatments include weight loss, avoiding sleeping on your back, avoiding alcohol before sleep, treating allergies and ensuring good sleep habits. 70% of our breathing at night should be from our nose – when our nose is blocked it leads to snoring. Nasal airway surgeries like Septoplasty, Turbinoplasty, Sinus Surgery, Balloon Sinuplasty and Latera Implants can be helpful. Surgery can also be done to improve breathing from the mouth by performing Tonsillectomy, Uvulectomy, Palate Surgery, and dental and jaw surgery. It is very important to not just treat the snoring – a comprehensive team of health experts including cardiologists, endocrinologists, psychiatrists, nutritionists, acupuncturists, physical therapists and holistic practitioners should be involved to ensure that all aspects of a snoring patient’s wellbeing are addressed to resolution.