Snoring...Sweet Dreams to Nightmares
Almost everyone snores. Even if you don't snore on a regular basis, chances are, you snore occasionally. Snoring is one of the most common sleep disorders that can be bothersome to the snorer's family and friends. Frequently, there are people whose motivation to see their physician comes from friends or neighbors complaining of their snoring. It's understandable since people's snores have been measured to be as loud as 90 decibels-roughly the equivalent of a jet at takeoff. Snoring can be frustrating to a sleep partner, sometimes even evoking anger and violence. Some snorer's end up with pillows thrust over the faces or rolled off of the bed onto the floor before getting their walking papers to the living room couch.
Why Do We Snore?
Dr. Robert del Junco of the Nasal & Sinus Center explains that the sound of snoring is caused when floppy tissues in the upper airway relax and then vibrate. When you sleep all the muscles in your body relax. Your throat is lined with muscles that keep the airway open. These muscles also relax when you sleep. The relaxed muscles cause your throat to narrow. For some people, the narrow opening blocks airflow, which can cause problems. Instead of breathing air smoothly into the lungs, air is inhaled quickly and with more pressure. As air travels down the air passage, picking up speed, it gets whipped around in every direction. As the air bounces around it hits the relaxed, floppy tissues lining the throat. When the tissues are hit by air they vibrate - that's the sound of snoring. People don't snore when they're awake because the muscles in the throat hold the airway open wide enough for air to smoothly flow into the lungs.
What Are the Treatments for Snoring?
There are 101 home remedies for snoring, ranging from wrapping a scarf around the nose and mouth to using certain drinks or sprays. Most don't work. The first line of treatment may be as simple as avoiding sleeping in the supine position, losing weight, or avoiding sedatives and alcohol prior to bedtime. Using decongestants, nasal steroid sprays, and other allergy treatments to relieve nasal congestion also may help. Accepted medical treatments for snoring are limited to oral appliances and upper airway surgery. There are many different oral appliances on the market, ranging from do-it-yourself to the more sophisticated models that dentists make. Oral appliances are small, unobtrusive devices whose side effects are limited to jaw joint pain from moving the lower jaw forward or tooth movement from anchoring the device. CPAP, or Continuous Positive Airway Pressure, is a breathing device that is more frequently used to treat sleep apnea.
Surgical Remedies for Severe Snoring
Upper airway surgeries include laser-assisted uvulopalatoplasty (LAUP), in which the surgeon uses a laser to cut away part of the soft palate, including the uvula. The soft palate is the major component in creating the snoring sound because it flutters as air passes through a narrowed pharyngeal airway (the throat). The surgeon may also remove other tissue (such as tonsils) or open the nasal passageways if those structures also contribute to the snoring. LAUP's are said to be greater than 80 percent effective in "decreasing" snoring, but their success rate in treating sleep apnea may be as little as 60 percent, so patients should be evaluated for apnea if they consider this procedure. Somnoplasty is a newer procedure that uses a radiofrequency probe; a needle with a microwave tip that heats a small amount of surrounded tissue and essentially melts it. The needle can be placed in the soft palate, the tongue, and the nasal turbinates (inner foldings of the nose) to shrink them. Somnoplasty has the advantage of a significant reduction of pain compared to the laser procedures.
A Final Word of Caution
People should know that snoring is a symptom of sleep apnea, which is a disease that has long-term health consequences such as hypertension, heart attack, strokes, etc. Since most of the above treatments (except CPAP) are much less effective in treating apnea than they are at treating snoring, people often require evaluation in a sleep center with a sleep test prior to their snoring treatment, and sometimes afterward.
An initial consultation with an ear, nose and throat specialist will help determine which treatment is best for you. Call 1-800-973-NOSE.