Snoring is a very common condition that affects both men and women. Anyone who’s been on the receiving end of someone who snores knows how disruptive it can be to a good night’s sleep.
Snoring is LOUD! In fact, the loudest recorded snore is 87 decibels, which is louder than a vacuum cleaner, and almost as loud as a lawnmower.1
Snoring is particularly frustrating because the snorer is normally completely unaware of the problem. They continue to sleep soundly while anyone within earshot has a sleepless night. As well as being a problem for a sleeping partner, snoring can also be a warning sign of obstructive sleep apnea. Obstructive sleep apnea has some serious implications for your health, so it’s important to exclude this as the cause of your snoring before deciding on treatment.
Causes of snoring
When you go to sleep, the muscles at the back of your throat relax. When this happens, your airway can narrow or close as you breathe. With your airway partly blocked a vibration occurs and snoring results.
Snoring can be made worse by sleeping on your back, having a narrow or blocked nose, or having a small lower jaw.
Drinking alcohol (especially near bedtime) and certain medications, can contribute to snoring. Cigarette smoking, which can irritate the nose and throat, is often blamed also.
Age. As you reach middle age and beyond, your throat becomes narrower, and the muscle tone in your throat decreases. While you can’t do anything about growing older, lifestyle changes, new bedtime routines, and throat exercises can all help to prevent snoring.
Being overweight or out of shape. Fatty tissue and poor muscle tone contribute to snoring. Even if you’re not overweight in general, carrying excess weight just around your neck or throat can cause snoring. Exercising and losing weight can sometimes be all it takes to end your snoring.
The way you’re built. Men have narrower air passages than women and are more likely to snore. A narrow throat, a cleft palate, enlarged adenoids, and other physical attributes that contribute to snoring are often hereditary. Again, while you have no control over your build or gender, you can control your snoring with the right lifestyle changes, bedtime routines, and throat exercises.
Nasal and sinus problems. Blocked airways or a stuffy nose make inhalation difficult and create a vacuum in the throat, leading to snoring.
Alcohol, smoking, and medications. Alcohol intake, smoking, and certain medications, such as tranquilizers like lorazepam (Ativan) and diazepam (Valium), can increase muscle relaxation leading to more snoring.
Sleep posture. Sleeping flat on your back causes the flesh of your throat to relax and block the airway. Changing your sleep position can help.
Ruling out more serious causes
Snoring could indicate sleep apnea, a serious sleep disorder where your breathing is briefly interrupted many times each night. Normal snoring doesn’t interfere with the quality of your sleep as much as sleep apnea, so if you’re suffering from extreme fatigue and sleepiness during the day, it could be an indication of sleep apnea or another sleep-related breathing problem. Call your doctor if you or your sleep partner have noticed any of the following red flags:
- You snore loudly and heavily and are tired during the day.
- You stop breathing, gasp, or choke during sleep.
- You fall asleep at inappropriate times, such as during a conversation or a meal.
Snoring is often associated with a sleep disorder called obstructive sleep apnea (OSA). Not all snorers have OSA, but if snoring is accompanied by any of the following symptoms, it may be an indication to see a doctor for further evaluation for OSA:
- Witnessed breathing pauses during sleep
- Excessive daytime sleepiness
- Difficulty concentrating
- Morning headaches
- Sore throat upon awakening
- Restless sleep
- Gasping or choking at night
- High blood pressure
- Chest pain at night
- Your snoring is so loud it’s disrupting your partner’s sleep
- In children, poor attention span, behavioral issues or poor performance in school
OSA often is characterized by loud snoring followed by periods of silence when breathing stops or nearly stops. Eventually, this reduction or pause in breathing may signal you to wake up, and you may awaken with a loud snort or gasping sound.
You may sleep lightly due to disrupted sleep. This pattern of breathing pauses may be repeated many times during the night.
People with obstructive sleep apnea usually experience periods when breathing slows or stops at least five times during every hour of sleep.
When to see a doctor if snoring
See your doctor if you have any of the above symptoms. These may indicate your snoring is associated with obstructive sleep apnea (OSA).
If your child snores, ask your pediatrician about it. Children can have OSA, too. Nose and throat problems — such as enlarged tonsils — and obesity often can narrow a child’s airway, which can lead to your child developing OSA.
Risk factors for snoring
Risk factors that may contribute to snoring include:
Being a man. Men are more likely to snore or have sleep apnea than are women.
Being overweight. People who are overweight or obese are more likely to snore or have obstructive sleep apnea.
Having a narrow airway. Some people may have a long soft palate, or large tonsils or adenoids, which can narrow the airway and cause snoring.
Drinking alcohol. Alcohol relaxes your throat muscles, increasing the risk of snoring.
Having nasal problems. If you have a structural defect in your airways, such as a deviated septum, or your nose is chronically congested, your risk of snoring is greater.
Having a family history of snoring or obstructive sleep apnea. Heredity is a potential risk factor for OSA.
Habitual snoring may be more than just a nuisance. Aside from disrupting a bed partner’s sleep, if snoring is associated with OSA, you may be at risk for other complications, including:
- Daytime sleepiness
- Frequent frustration or anger
- Difficulty concentrating
- A greater risk of high blood pressure, heart conditions, and stroke
- An increased risk of behavior problems, such as aggression or learning problems, in children with OSA
- An increased risk of motor vehicle accidents due to lack of sleep
Should I get my snoring checked out?
- If you snore, you should see your GP to make sure you don’t have obstructive sleep apnea.
- If the answer is yes to any of the following, your risk is increased:²
- I snore loudly
- I feel sleepy or fall asleep during the day
- I’m told I make gasping or choking sounds while I sleep
- I’m told I stop breathing while I sleep
- I have high blood pressure
- I’m overweight
- I’m male
- I’m aged over 50
- I have a large neck size
If your GP thinks your snoring may be a sign of obstructive sleep apnea, he or she may ask you to undertake a sleep apnea assessment.
Treatments for sleep apnea often work for snoring too, even if you don’t have sleep apnea. In addition, snoring can be treated with other techniques, including implants in your soft palate, laser surgery, and radiofrequency ablation.3
One of the simplest treatments is a method that is also used for obstructive sleep apnea called Continuous Open Airway Therapy (COAT™) by SomnoMed.
Worn in your mouth while you sleep, a SomnoMed COAT device moves your lower jaw forward to prevent your tongue and the soft tissue in your mouth falling back and blocking your airway while you sleep.
SomnoMed manufactures the world’s leading COAT device. It’s called SomnoDent® and it’s available in Australia from specially trained dentists.
Theravent Snoring Therapy is available in Australia for patients with snoring (but no obstructive sleep apnoea). The treatment involves small adhesive devices that cover the nostrils. Similar to Provent Therapy, the unique valve system is designed to eliminate snoring by increasing the pressure inside the airway.
Theravent is an effective treatment for many patients with troublesome snoring, particularly when combined with other conservative snoring treatments (including lateral sleep and weight-reduction).
Exclusively Lateral Sleep
Exclusively lateral sleep can be an effective, non-invasive treatment of snoring and obstructive sleep apnoea. It achieves this by preventing the tongue, soft palate and uvula from falling backwards under the effect of gravity, thereby causing the pharyngeal airway to be restricted. This, in turn, results in an increased speed of air-flow through the narrowed airway, causing an increase in soft-tissue vibration and resultant snoring. A variety of simple measures can be implemented to encourage exclusively lateral sleep, such as the use of a bolster pillow placed lengthwise in the bed (to lean against) or pinning tennis balls (or the like) to the back of a pyjama top. As the tennis ball causes discomfort to the wearer when supine, it typically causes the wearer to turn back to a lateral position. Within a few weeks, most people learn the habit of sleeping laterally and will no longer require tennis balls or similar measures. Exclusively lateral sleep is limited however in its effectiveness, particularly in sufferers with severe obstructive sleep apnoea. In this case, alternative treatments are required.
Night Shift Device
Nightshift is a new lateral sleep position aid that assists patients to sleep exclusively on their side. Many patients have obstructive sleep apnoea that is significantly worse (or only present) when sleeping on their back (the supine position). The device accurately monitors sleep-position and vibrates when supine sleep is detected, helping many patients with position-related airway disorders to avoid other OSA treatments. It records positional data and snoring volumes that can be downloaded, either to provide you with information on your sleep or to provide to your Sleep Physician to monitor the progress of your treatment.
Night Shift can also be used in conjunction with other OSA treatments, including Provent Therapy. Patients who require CPAP can use Night Shift as well to lower their nightly CPAP setting.
For ethical reasons, we do not sell Night Shift or any other treatment device, but our doctors may recommend a trial based on the results of your sleep study.
Weight loss will generally decrease the severity of snoring, although not all people who snore are overweight, weight gain will typically make existing snoring even worse. Losing even a little weight can reduce fatty tissue in the back of the throat and decrease snoring. In some patients, weight loss may not cure snoring, but can significantly reduce its loudness (sometimes to such an extent that other treatments are not required).
Cessation of Tobacco Smoking
In addition to causing cancer and being a major health risk, tobacco smoke causes the walls of airways to retain fluid and swell (this is called oedema). This causes the airway to narrow, worsening snoring (and sleep apnoea). Smokers are 4 to 5 times more likely than non-smokers to suffer from snoring and obstructive sleep apnoea. Nicotine also contributes to insomnia and poor sleep habits.
Mandibular Advancement Splint (MAS)
A Mandibular Advancement Splint is a small device (a type of dental splint) that is placed in the mouth during sleep, causing the lower jaw and tongue to be held more forward than usual. This, in turn, opens the pharyngeal airway, resulting in a lower rate of air-flow. This minimizes vibration of the tissues at the back of the pharynx, thereby reducing the volume of snoring. However, there are a number of problems which can occur for users of a MAS, including a build-up of excessive amounts of saliva, discomfort of jaws and teeth, problems with the gums and other oral tissues with certain types of MAS, particularly if fitted incorrectly and in a significant percentage of patients, permanent repositioning of the teeth and an altered bite over a period of years.
Continuous Positive Airway Pressure (CPAP)
As for obstructive sleep apnoea (OSA), CPAP is currently the most effective treatment for simple snoring. CPAP involves the use of a compact air pump to deliver a continuous flow of pressurized air (via a mask) to an individual’s airway. This pressurized air acts as a pneumatic splint and prevents the airway from collapsing, which in turn causes snoring to cease. Each individual’s pressure-requirement differs, depending on a variety of factors, including the weight and severity of snoring. These and other details of
CPAP therapy is discussed in the CPAP section of this website.
Nasal Steroids and Allergy Treatments
Naso-pharyngeal congestion from allergies can also contribute to a narrowing of the airways. Nasal congestion limits the amount of air a person can breathe through their nose while asleep. This can be caused by the presence of an allergen in an individual’s immediate environment, resulting in an inflammatory response and mucosal swelling, which blocks the nose. Mouth-breathing is then the only available means to ensure that sufficient oxygen is delivered to the body. Nasal steroids can be an effective way to combat the underlying allergic reaction, eg, with prescription agents such as ‘Nasonex’. Certain over-the-counter nasal steroids are also available from pharmacies.
Non-Steroidal Over-The-Counter Nasal Sprays and Other Anti-Allergy Treatments
Other over-the-counter treatments may also be beneficial in patients prone to nasal allergies or troublesome nasal congestion at night-time. The most common cause of nasal congestion is temporary swelling of nasal passages due to colds or allergic reactions to pollen, dust, mold, animals or some foods. These can cause the lining of the nasal membrane to become inflamed, and mucus to thicken and become acidic. There are a number of over-the-counter nasal sprays that can be helpful in the short term, eg, FESS® Nasal Spray, a non-medicated saline nasal spray. Nasal sprays like Afrin, Neo-Synephrine, NasalCrom (Cromyln) and anti-histamines can also be useful as decongestants. However, the use of such sprays for more than 72 hours can cause a rebound, negative effect. Allergy desensitization treatments will sometimes be recommended by a Sleep Physician, Allergist or General Practitioner.
ENT Interventions and Surgery and Other Procedures on the Soft Palate
When narrowing is due to structural abnormality, ENT surgery can be very helpful as a means of opening the nasal passages, thereby improving nasal air-flow and eliminating the sufferer’s need for mouth-breathing.
Surgical procedures that have been used in the hope of reducing snoring include uvulopalatopharyngectomy (UPPP), radiofrequency uvulopalatopharyngectomy (RFUPPP) and laser-assisted uvuloplasty (LUAP). These treatments tend to be painful and expensive, and they often fail to cure snoring, especially when this is loud. They have no place as a treatment for snorers who also suffer from moderate or severe OSA (and in fact, can complicate later treatment of OSA with CPAP).
Injection snoreplasty is a nonsurgical treatment for snoring whereby the soft palate is injected in front of the uvula with a hardening agent. This creates an inflammatory reaction and results in scar tissue, which in turn stiffens the soft palate and ultimately reduces the amount of palatal tissue ‘flutter’. When this is the cause of snoring, the treatment can result in reduced snoring volume. Unfortunately, a number of other pharyngeal tissues can vibrate and cause snoring and this technique cannot assist when this is the case. Also, this is presently a new treatment, with limited long-term evidence of its effectiveness.
External Nasal Strips
Nasal strips such as ‘Breathe Right’ appear to reduce snoring in some patients through opening the nasal passages, but there are no published scientific studies that definitely prove that these strips do in fact assist significantly with snoring. These strips probably have their main place in the 5-10% of individuals whose nostrils collapse during inspiration.
Nocturnal Sedatives and Alcohol
Nocturnal sedatives (such as sleeping pills) and alcohol (especially in large quantities) can cause narrowing of the pharynx as a result of the relaxation of pharyngeal muscles, with a resulting increase in soft-tissue vibration and snoring. Reducing the intake of these agents commonly, therefore, helps to reduce snoring volume.
Natural Solutions and Lifestyle Changes
Change Your Sleep Position.
Lying on your back makes the base of your tongue and soft palate collapse to the back wall of your throat, causing a vibrating sound during sleep. Sleeping on your side may help prevent this.
“A body pillow (a full-length pillow that supports your entire body) provides an easy fix,” Slaughter says. “It enables you to maintain sleeping on your side and can make a dramatic difference.”
Taping tennis balls to the back of your pajamas can also stop you from sleeping on your back, Chokroverty says. “Or you can recline the bed with the head up and extended, which opens up nasal airway passages and may help prevent snoring. This may cause neck pain, however.” If snoring continues regardless of the sleep position, obstructive sleep apnea may be a cause. “See a doctor in this case,” Chokroverty says.
Weight loss helps some people but not everyone. “Thin people snore, too,” Slaughter says.
If you’ve gained weight and started snoring and did not snore before you gained weight, weight loss may help. “If you gain weight around your neck, it squeezes the internal diameter of the throat, making it more likely to collapse during sleep, triggering snoring,” Slaughter says.
Alcohol and sedatives reduce the resting tone of the muscles in the back of your throat, making it more likely you’ll snore. “Drinking alcohol four to five hours before sleeping makes snoring worse,” Chokroverty says. “People who don’t normally snore will snore after drinking alcohol.”
Practice Good Sleep Hygiene.
Poor sleep habits (also known as poor sleep “hygiene”) can have an effect similar to that of drinking alcohol, Slaughter says. Working long hours without enough sleep, for example, means when you finally hit the sack you’re overtired. “You sleep hard and deep, and the muscles become floppier, which creates snoring,” Slaughter says.
Open Nasal Passages.
If snoring starts in your nose, keeping nasal passages open may help. It allows air to move through slower, Slaughter says. “Imagine a narrow garden hose with water running through. The narrower the hose, the faster the water rushes through.”
Your nasal passages work similarly. If your nose is clogged or narrowed due to a cold or another blockage, the fast-moving air is more likely to produce snoring.
A hot shower before you go to bed can help open nasal passages, Slaughter says. Also, keep a bottle of saltwater rinse in the shower. “Rinse your nose out with it while you’re showering to help open up passages,” Slaughter says.
A neti pot could also be used to rinse out the nasal passages with a salt-water solution.
Nasal strips may also work to lift nasal passages and open them up — if the problem exists in your nose and not within the soft palate.
Change Your Pillows.
Allergens in your bedroom and in your pillow may contribute to snoring. When did you last dust the overhead ceiling fan? Replace your pillows?
Dust mites accumulate in pillows and can cause allergic reactions that can lead to snoring. Allowing pets to sleep on the bed causes you to breathe in animal dander, another common irritant.
“If you feel fine during the day but obstructed at night, these things may be contributing to your snoring,” Slaughter says.
Put your pillows in the air fluff cycle once every couple weeks and replace them every six months to keep dust mites and allergens to a minimum. And keep pets out of the bedroom.
Beware before spending money on special pillows designed to prevent snoring, Chokroverty says. “They may work if it props up your head, which fixes nasal issues, but can cause neck pain.”
Stay Well Hydrated.
Drink plenty of fluids. “Secretions in your nose and soft palate become stickier when you’re dehydrated,” Slaughter says. “This can create more snoring.” According to the Institute of Medicine, healthy women should have about 11 cups of total water (from all drinks and food) a day; men require about 16 cups.
Overall, get enough sleep, sleep on your side, avoid alcohol before bedtime and take a hot shower if nasal passages are clogged, Slaughter says. “These simple practices can make a huge difference in reducing snoring.”
Frequently Asked Questions About Snoring
Why do people snore?
You snore when some parts of your throat vibrate. This only happens when you’re asleep. The part of your throat that vibrates is called the pharynx. It is right behind the tongue. Several small muscles hold it open. But when you sleep, these muscles relax. This makes it vibrate more easily. It also becomes narrower. When you breathe in, it will vibrate and make a noise. The narrower it is, the more easily it will vibrate and the louder you will snore.
How common is snoring?
About 40% of men have at least mild snoring, on at least some nights. This number is smaller for women (around 30%). About 15% of people snore on most nights. People of any age can snore. Even some children have a problem with snoring. But the age group most at risk are middle-aged people.
What can raise my risk of snoring?
- Being overweight or obese will mean you have more fat around the neck. This will make your throat narrower and it will vibrate more easily.
- Drinking alcohol will relax the muscles in your throat. This will mean more vibration and more sound.
- People who breathe through the mouth are more likely to snore. This is because the walls of your throat at the back of the mouth vibrate easily. Walls at the back of your nose do not vibrate as easily.
- A blocked nose will mean that you have to breathe through the mouth. This will raise your risk of snoring. It also makes a vacuum inside the throat. This may pull the walls of your throat closer together.
- Sleeping on your back makes your tongue fall directly back. This can get in the way of your airflow. Snoring is almost always worse on the back.
- Some people snore because of narrowing caused by nasal polyps, a large tongue or thyroid swellings. These narrow the airway. Often children snore because of large tonsils and adenoids.
- Allergies, hay fever, and smoking can make snoring worse. This is because they make it harder for air to flow in and out.
- Some medications make your throat muscles relax e.g. sleeping tablets, anesthetic drugs, oral steroids, and epilepsy drugs.
- Some people are born with a smaller airway than normal. These people will have a higher chance of snoring.
- Snoring is more likely in pregnancy (see Pregnancy and Sleep)
How does it affect people?
For many families, snoring is a big problem. Often, the snorer has to sleep alone in another room. If not, then his or her family will have trouble getting a good night’s sleep. The family might be more tired during the day. This can mean that they can’t focus as well on work or study. Some snorers also have a condition known as sleep apnea. Over 10% of regular snorers have this condition to a significant degree. Sleep apnea is linked to high blood pressure, heart attacks, and strokes.
How is snoring treated?
One treatment is called a Mandibular Advancement Splint. It looks a bit like a mouthguard. You wear it between your teeth while you sleep. It pushes your lower jaw forward. This gives you a wider airway. It needs to be specially fitted to you. You will need to see a dentist or oral surgeon for this. This is because different people have different mouth shapes. It works for some people but not for others. (See Oral Appliances)
Some treatments stiffen the roof of your mouth. This makes it vibrate less. This can be done using lasers, microwave rays or injections. Laser surgery on the throat may work for some people. But it can be painful. Only an Ear, Nose and Throat surgeon can do this.
For children who snore, it is common to take out the tonsils as tonsillar enlargement is a common cause. This often succeeds. (see Childhood Snoring and Obstructive Sleep Apnea) For adults with large tonsils, the same thing can also be done.
Some people snore because of the shape of their tongue or the roof of their mouth. Others snore because their nose is blocked. In all of these cases, surgery in the problem area can help. A type of surgery called uvulopalatopharyngoplasty (UPPP) used to be common. Here, the surgeon operates on the back of the throat to make it wider. But it only ever worked for some people and has a low success rate in the long term.
Positional therapies to encourage you to sleep on your side can be helpful but are often ineffective in keeping you on your side throughout sleep.
Herbal or enzyme treatments might help with allergies. If this is why you snore, then they might help. But if you’re snoring for another reason, then they will do nothing.
Nasal dilator strips can unblock your nose. But by themselves, they won’t stop snoring.
What might your doctor do?
Problem snoring may be an early warning signal that sleep apnoea is present. Your GP can refer you to a sleep specialist who will probably want you to do a sleep study. Sleep Apnea is a serious health issue that needs attention.
What could you do?
If you are overweight, losing weight might help. Try and avoid alcohol for at least four hours before sleeping. If your snoring is made worse by an allergy, try and stay away from whatever sets it off.
Where and when should you seek help?
Get help if your snoring is bothering you or your household. If you see a doctor about snoring, you might want to bring your partner with you, if you have one. This is so that they can talk to the doctor about what happens when you’re asleep.
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