Is snoring waking you up at night?
Whether you’re the snorer or the reluctant audience of someone else’s nightly noise-making, these interruptions are likely taking a toll on the quality of your sleep.
This guide is designed to help you gain an understanding of why people snore, and what you can do to prevent it.
What Is Snoring?
Most of us are familiar with what snoring sounds like: that hoarse, droning sound made while someone is sleeping which is often likened to a lawnmower or buzzsaw. While as many as half of us are occasional snorers the actual source of these nighttime noises is less widely understood.
All sounds are the result of something vibrating.
So what’s vibrating when someone snores? When we are asleep, the tissues at the back of our throat and roof of our mouths relax, and so -- given the right circumstances -- breathing in can cause them to vibrate and create the array of sounds we so affectionately call snoring.
Absolutely anyone can snore, and most of us will at some point or another. This type of occasional snoring is typically not something you should be concerned with -- although your bed partner might have something else to say about that.
If however, you find yourself snoring regularly it can significantly impact the quality of your sleep (and those around you, as they’ll likely inform you.)
Snoring And The Sleep Stages
Sleep is not a homogenous state, it’s actual divided into 4 distinct stages. More generally, these are categorized as non-REM and REM (rapid eye movement) sleep. While someone can snore during any stage of sleep, it’s most often associated with REM sleep due to the unique characteristics of this stage.
During REM sleep, your brain shuts down the activity of your muscles, causing an overall loss of muscle tone. This paralysis of the peripheral muscles is responsible for the eerie sleep phenomenon sleep paralysis; and when disrupted can lead to sleep movement disorders.
In certain people this loss of muscle tone can cause the tissues of the tongue, palate and throat to effectively collapse. This narrows the airway and greatly increases your chances of snoring.
3 Types Of Snores
If you’ve ever had the opportunity to listen to several individuals snore, you’ll notice that not all snores are alike. While there’s no official terminology used to describe these different types of snores, there are characteristics that can be used to distinguish between them.
“Conventional” snoring typically follows a particular rhythm and sounds a lot like just noisy breathing. On the other hand, snoring patterns that include loud snorting followed by complete silence are indicative of a more serious problem. This type of snore happens as the airway reopens following collapse and suggest you may be suffering from sleep apnea.
These different types of snores also tend to happen during different sleep stages :
- Disordered snoring is the NOT likely to occur during deep non-REM sleep.
- Conventional snores on the other hand typically happen during deep sleep.
- Snoring caused by a disorder is MOST likely to arise during REM sleep.
Risk Factors That May Contribute to Snoring
There are certain factors that put you at a greater risk of snoring. While some of these can be managed, others, unfortunately, are simply chopped up to your biology.
- Male: Studies show that men are more prone to snoring than women. In fact, while 1/3rd of men suffer chronic snoring only 1/5th of women experience the same.
- Overweight: Being overweight puts more pressure on your airway and is associated with a higher rate of snoring and obstructive sleep apnea.
- Age: Snoring tends to worsen with age due to loss of muscle tone.
- Family history of snoring or obstructive sleep apnea: Snoring tends to run in families, if one of your parents snores it’s more likely you will as well.
What Causes Snoring?
We’ve already been over the basics of snoring, and that it happens when the air flowing through your mouth and nose is obstructed in some way. Now it’s time to take a more in depth look at the reasons why you may be experiencing an obstruction.
Some people are simply built in a way that promotes snoring. Have a thick soft palate, an elongated uvula (that teardrop shaped piece of tissue that hangs at the back of your throat), large tonsils or adenoids can all cause your airway to be narrower than average.
Being overweight can cause these tissues to enlarge -- resulting in what is known as a bulky throat. Having a deviated septum (when the cartilage separating your two nostrils is off-center) may cause snoring if it’s sufficient to cause issues with breathing through your nose.
Additionally, having a receding chin may also lead to throat obstruction while sleeping in certain positions.
Snoring can likewise be caused by problems with airflow through your nose. Seasonal allergies and sinus infections are often the culprit when it comes to occasional snoring. However, as mentioned above, certain structural conditions such as a deviated septum may cause chronic nasal obstruction.
Poor Muscle Tone
If the muscles of your tongue and throat are too relaxed they’re prone to collapse when you are asleep, blocking your airway. While age and genetics are often the primary cause of poor muscle tone, substances such as alcohol and certain sleeping pills can contribute to this effect.
The most common cause of snoring in adults is nasal obstruction due to a cold or allergies. Whereas in children, when snoring is seen more rarely, it’s more often due to enlarged tonsils.
There is evidence to suggest that not getting enough sleep can lead to greater relaxation in your mouth and throat muscles when you do sleep. In this way you may find yourself caught in a cycle where sleep deprivation caused by your snoring results in more snoring, which means more sleep disruption.... I think you get the point.
Sleeping Position and Snoring
When we lie down to sleep gravity has an effect on all the tissues of our body; and, since the tissues in our mouths and throats are soft and floppy they have a tendency to be pulled backwards into our airway. However, there are certain sleep positions that better and others that are worse for snoring.
Sleeping on your back is by far the worst position to be in if you’re a snorer. Lying down this way quite simply invites gravity to pull your tongue and soft palate backwards into your throat. In contrast, when you sleep on your side the structures of your airway tend to be better stabilized and there’s less of a chance they’ll collapse and cause an obstruction.
Even if sleeping on your side doesn’t completely remedy your snoring, studies show that it greatly reduces its severity.
Snoring and Sleep Apnea
Sometimes snoring is a symptom of a more serious sleep disorder called sleep apnea. Snoring as we typically think of it is more likely to result from obstructive sleep apnea (OSA) than the other manifestation of the disorder which is due to a disruption in the function of the lungs while asleep.
OSA causes your airway to become so blocked that you struggle to breathe as you sleep. People with OSA may snore very loudly, then suddenly there is a pause of silence during which breathing nearly stops or stops completely. The resulting drop in blood oxygen level then causes the sleeper to wake suddenly with a gasp or snort.
Health Consequences & Side Effects Of Snoring
There’s a lot of evidence that snoring, aside from annoying your bed partner, can have a negatively impact on your health. While occasional snoring is for the most part benign, studies have shown that habitual snoring puts you at a higher risk of many serious health complications.
One study revealed that snoring is associated with an increase in risk of stroke. More specifically, the intensity of your snores promotes the collection of plaque in the arteries of your neck causing them to narrow. So, the louder you snore the greater your risk.
Snoring, especially when associated with sleep apnea, is linked with an increase in blood pressure and development of coronary artery disease. Data indicates that people with sleep apnea are two times are likely to have a heart attack as the general population.
Over the long run, snoring can cause you to develop an abnormal heart rhythm (known as an arrhythmia.) While this is a particular concern among those suffering from sleep apnea, studies suggest that all snorers may be at risk.
Low Blood Oxygen Levels
Simply put, if you’re not breathing normally you’re not introducing the right amounts of oxygen into your body. What’s more, you’re not expelling the waste carbon dioxide optimally either. Over an extended period of time this may cause you to develop pulmonary hypertension.
Many people who snore report suffering from headaches in the morning. These chronic headaches are believed to be caused by the fluctuations in the levels of oxygen and carbon dioxide in your blood while you’re sleeping.
Due to the way the throat closes while breathing to produce snoring you could develop gastroesophageal reflux disease. The pressure changes caused by this obstruction can actually be sufficient to suck the contents of your stomach up into your esophagus. This is especially prevalent among those who are overweight.
Excessive Daytime Sleepiness
This one is not reserved solely for snorers themselves, but also the people trying to sleep next to them. Excessive Daytime Sleepiness is characterized by feelings of extreme drowsiness during the day, and it can significantly impact your ability to perform at work as well as fulfill other daily activities.
If your snoring is severe enough that it’s causing you to be sleep deprived, you have an increased likelihood of experiencing an accident resulting in injury. Intense daytime sleepiness clouds your judgement, makes it difficult to concentrate, and can even cause you to fall asleep at the wheel. You should be wary of driving and performing other activities that could put you or others at risk.
Long-term sleep deprivation takes a toll on your mental health: From making it difficult to regulate your mood and lowering your frustration threshold, to contributing to the development of clinical depression and anxiety.
Should I See My Doctor?
While the occasional bout of snoring is usually not something you need worry about, if you’re snoring regularly you should discuss your symptoms with your doctor. If your child is snoring without any obvious cause -- such as an infection -- you should always tell your pediatrician.
Snoring in children is more often associated with a nose or throat problem; and even in early years kids may suffer from obstructive sleep apnea.
Your Doctors Appointment
The main goal of your appointment will be to rule out any underlying condition causing your snoring, or obstructive sleep apnea. To do this your doctor will perform a physical examination and ask detailed questions regarding your symptoms.
Measurements such as your body mass index (BMI) and neck circumference can help determine if your body weight is causing your symptoms. You may also have imaging or scoping done of your throat, nasal and oral cavities to see if they are abnormally narrow.
Your doctor may also wish to talk with your partner (or another person familiar with your snoring.) This witness can help reveal important information about the severity of your snoring and whether or not you experience pauses in breathing (apneas) during the night.
They may also have noticed other concerning signs, such as jerking movement in your legs which could be caused by other sleep disorders.
You may be referred to a sleep specialist if a more serious sleep disorder is suspected.
Tests Used To Diagnose The Cause Of Snoring
Epworth Sleepiness Scale
Not exactly a test, but the Epworth Sleepiness Scale helps determine the severity of your daytime sleepiness. The patient is asked to rate the likelihood that they will fall asleep during a selection of activities on a scale from 0 to 3.
- 0 = Unlikely to fall asleep
- 1 = Slight risk of falling asleep
- 2 = Moderate risk of falling asleep
- 3 = High likelihood of falling asleep
Risk of Dozing
Sitting and reading
Sitting inactive in a public place
As a passenger in a car riding for an hour, no breaks
Lying down to rest in the afternoon
Sitting and talking with someone
Sitting quietly after lunch, without alcohol
In a car, while stopped for a few minutes in traffic
The numbers are then added together to calculate your total score, ranging between 0-24 with the highest scores indicate greater sleepiness.
The Epworth Sleepiness Scale is useful in diagnosing snoring as a score less than 10 usually indicates there is no underlying cause; while disorders such as sleep apnea result in a scores of 16 and higher.
X-rays, CT scan and MRIs can be used to capture images of the structures of your mouth, nose and throat. Imaging studies such as these will reveal structural abnormalities, like a deviated septum.
A sleep study or polysomnography can either be conducted at home or in a specialized center. Depending on which version of the exam you undergo, a variety of measures will be taken while you sleep, such as your heart and breathing rate, brain waves, eye and leg movement, as well as blood oxygen levels.
Snoring Solutions, Treatments & Home Remedies - How Can I Stop Snoring?
There are many different techniques to help curb your snoring problem: From conservative lifestyle changes, to medical implants and surgery. It’s recommended that everyone sees how their symptoms respond to less invasive options before considering more drastic measures.
Snoring Remedies You Can Try At Home
- Lose Weight: For many people that are overweight, shedding those extra pounds is all that’s necessary to put an end to their snoring. Adopting a healthy diet and exercise routine also comes with the additional benefit of helping regulating your sleep cycles for an overall improvement in sleep quality.
- Sleep on your side: Laying on your side is the best sleep position for snoring preventing. However, changing this habit can be tricky at times, and many people find themselves turning onto their backs during the night.
One recommendation is to tape or sew a tennis ball to your t-shirt at the small of your back, which will serve as a reminder to remain on your side.
- Raise the head of your bed: Raising your chest and head by 4-inches or so, by using wedge pillows or placing additionally support under the head of your mattress may help if you simply cannot adjust to sleeping on your side.
This position will relieve some of the pressure of gravity and can prevent your soft palate or tongue from slipping backwards.
- Quit smoking: If you’re a smoker here’s yet another reason to quit. Smoking irritates your throat and nasal tissues, exacerbating snoring.
- Avoid alcohol before bed: Alcohol can cause your muscles to become overly relaxed while you sleep. If you’re going to be drinking, try to have your last drink at least 2 hours prior to bedtime.
Sedative medications can have a similar effect. If you’re prescribed a sedative for another condition talk to your doctor about your snoring and possible alternatives.
- Get adequate sleep: Avoid sleep deprivation by practicing sleep hygiene and aiming for the right amount of sleep. Adults need at least 7 to 8 hours per day, while children should get as much as 12.
If snoring is waking you up at night, try penciling in some naps in your schedule to make up for that lost time.
Medical Devices To Treat Snoring
There are also a variety of medical devices that are used to treat snoring that doesn’t respond to lifestyle changes alone. Each device works by helping to keep the throat, mouth or nasal passages open while you sleep.
There are different styles of devices that are worn in the mouth. These are either designed to hold the tongue forward or keep the palate from falling down and back. Also called oral appliances, these devices are typically fitted to each individual by a dentist or a specialized doctor.
The drawback to these devices is that many people find it difficult to adjust to wearing them while they sleep. However, studies suggest that they’re effective in treating primary snoring and mild sleep apnea in 70% to 90% of cases.
Nasal Devices & Medications
If narrow nasal passages, a deviated septum or chronic congestion are behind your snoring you may find relief with the use of certain medications and devices designed to open your airway.
Strips which are applied on top of the nose help open up the anterior nasal valve. However, this technique will only relieve your symptoms if narrowing of this area is the only or primary cause of your snoring -- which is not usually the case.
Swelling of the lining of your nasal passages -- due to allergies or infection -- can be alleviated with the use of different sprays: from simple saline washes to ones containing steroids. These help to clear out irritants and decrease inflammation. You may also take decongestant medications.
Continuous positive airway pressure (CPAP) is a specialized device used to treat obstructive sleep apnea. The machine consists of an air pump and a mask which when worn prevents your airway from collapsing by providing constant air pressure. A specialist will help determine what air pressure is suitable for each individual.
While CPAP is proven to be highly effective in improving snoring and sleep apnea, people often experience discomfort that ultimately leads to them not using the machine. If you’ve been prescribed a CPAP machine and are having difficulty, talk to your doctor before stopping treatment.
Surgical Options To Treat Snoring
In severe cases, or ones in which an identified defect that does not respond to more conservative treatments you may be offered a surgical intervention. The typical targets of snoring surgeries are the nasal passages, palate, uvula and tongue.
You should undergo a sleep study and a trial period on CPAP before considering surgery. This is primarily to rule out sleep apnea, as a surgery may reduce the sound of snoring but leave the underlying cause untreated -- effectively masking your condition.
Radio-Frequency Energy: These procedures can be carried out in your doctor’s office and use radio-frequency energy to shrink tissues inside the nose. It only takes around 15 minutes, but since the effect requires scar tissue to form it can take up to three months to feel the full effects.
Additionally, since scar tissue tends to soften with time, you may have to undergo the procedure again in the future.
Deviated Septum: Your septum is the wall down the center of your nose that separates your two nasal passages. If a deviated septum is causing a blockage on one side, you can have the crooked cartilage removed to improve airflow.
Nasal Polyps: Allergies can sometimes cause polyps to grow on your mucosal membranes which can result in chronic nasal obstruction. This surgery will require a trip to the OR and going under general anesthesia.
Uvulectomy: If a vibrating uvula is responsible for your snoring you can have it removed in an uvulectomy. Most people do not experience any issues living without an uvula; although the procedure does require a healing time of approximately two weeks wherein you may suffer from pain and discomfort.
However, if you speak a language that requires the use of guttural fricatives (such as Hebrew or Farsi), it’s not recommended you undergo an uvulectomy as it could impair your speech. English, on the other hand, does not use any guttural fricatives.
Laser Assisted Uvulopalatoplasty (LAUP): A long, floppy palate can be treated using Laser Assisted Uvulopalatoplasty. LAUP is another procedure that can be undertaken in your doctor’s office. It involves the use of a laser to make small cuts in the palate on either side of the uvula.
Once healed, the scarring helps to make the palate stiffer, which decreases vibration. However, it requires several treatments to be effective.
There are newer methods to create scar tissue for a similar effect, including injections, radiofrequency ablation, cold ablation and palatoplasty.
Palate Implants: The latest technology in snoring treatment involves the use of palate implants. These are created with the same material as that used in heart valve surgery and hernia repairs, called Dacron. This non-reactive material is injected into the palate to make it more stiff.
Often multiple implants are required in order to have the maximum effect, and if you have a very long floppy palate this procedure is unlikely to successfully dampen your snoring. People who have palatal implants typically report less pain during recovery than those who underwent radio-frequency procedures.
Does Your Partner Snore? Helpful Tips to Ignore Snoring
Snoring doesn’t just affect the snorer. In fact, if the person snoring isn’t experiencing any associated disruption in their sleep, it may be you who suffering the brunt of the consequences of their noisy habit.
Being kept up at night by a noisy bed partner can leave you feeling exhausted and -- let’s face it -- frustrated. You should talk to your partner about enacting the behavioral changes we went over in the above section; and, if you suspect their condition is serious, urge them to talk to their doctor.
While waiting for a more permanent solution to your nocturnal troubles, there are certain things you can undertake to help improve your sleep and drown out a noisy partner.
- Ear Plugs: Ultimately ear plugs might be the most effective tool in helping you to sleep through your partner’s snoring. However, many people don’t find them comfortable and cannot adjust to wearing them at night.
- White Noise Machines: These machines are designed to produce sounds specially designed to mask noises like snoring. Nowadays there are countless smartphone applications that can fulfill the role of a dedicated machine, and, in a pinch many people find a simple electric fan to be effective.
- Listen to music: Similar to wearing earplugs, many people find listening to music or podcasts using earphones can help them sleep through a variety of disturbing noises, including snoring.
- Separate Beds: If your partner is a particularly noisy snorer then there have likely already been nights where either you or them has gone to sleep in another room. For some couples this can be the ideal solution to solve relationship problems caused by snoring.
You’ll also want to establish effective coping strategies for those times that you are woken up by your partner’s nocturnal refrain. If you allow yourself to become overly frustrated and stressed you’ll find it even more difficult to fall back to sleep.
Plan ahead and prepare yourself mentally for the possibility, then -- if and when you find yourself startled awake -- perform some relaxing behaviors to lull yourself back.
- Avoid checking the time: Staring at the clock will not only lead you to solemnly discover you only have two hours left before your alarm rings, but the bright light can stimulate your brain and increase your state of alertness.
- Take deep, soothing breaths: With your eyes closed, breathe deeply and slowly, in and out through the nose. Breathing techniques such as this are designed to calm your nervous system and promote relaxation and sleep.
- Perform a meditation: Many people respond very well to visualization and meditation. If you’re listening to music on earphones already, you can queue up a guided meditation designed to bring on sleep.