What is Snoring?
Most people regard snoring as nothing more than an embarrassing annoyance that keeps others awake. However, it could actually be a symptom of a breathing disorder known as obstructive sleep apnea. Since millions of people suffer from snoring, it is important to find out if the nocturnal nuisance may suggest something more problematic.
It refers to a noisy sound that is produced by vibrations of the soft palates and other tissues in the mouth, throat or nose.
It is caused by obstructed air movement due to a partial blockage that may be traced to anywhere from the vocal chords to the nostrils.
It most commonly occurs in the throat, when your respiratory structures are in a relaxed state during sleep.
When you are asleep, your throat muscles and soft palate relaxes as your uvula (a fatty tissue that hangs in the middle of your throat) hangs looser. The air that you breathe causes the fatty tissue in your throat to vibrate, generating the snoring sounds. When the throat and soft palate relaxes to a point that partially obstructs your airway, the vibrations are intensified as the air is being forced through a narrower entrance at greater pressure.
It is a very common condition occurring in 45% of men and 30% of women.
The condition is frequently found in individuals who are overweight or obese. The propensity for the nocturnal habit increases with age. Although largely considered a mild affliction, snoring can worsen over time and may be the first sign of obstructive sleep apnea.
It can indicate the existence of obstructive sleep apnea but it does not mean that you have the breathing disorder simply because you snore.
Although snoring should be considered as one of many risk factors, it must be acknowledged that loud, constant and prolonged snoring is symptomatic of OSA. If you have been keeping others awake with loud and incessant snoring, perhaps this is a good enough reason to be visiting your health professional for a check-up and diagnosis.
What are the risk factors of snoring?
The following factors that may put you at risk include:
Obesity: Overweight and obese individuals are more prone to become snorers. That’s because fatty cells tend to congregate and clog the tissues of the throat. In so doing, the fatty tissues cause the airway to narrow. People who are overweight and suffering from obstructive sleep apnea also tend to have more pressure on their airway that exacerbates the obstruction and snoring issue.
Anatomical abnormalities: A person may be more pre-disposed to snoring due to certain anatomical abnormalities hence there is also greater possibility that they will develop obstructive sleep apnea. The shape of the person’s neck and head can directly affect the size of the airway. For example, a thicker neck, enlarged tonsils and large tongue may adversely impact the passage of air. People with craniofacial syndromes may suffer from structural abnormalities in the mouth, nose or jaw that make them more susceptible to the breathing disorder.
Age: People over the age of 65 are two or three times more than likely to develop obstructive sleep apnea.
Gender: It is a well-known fact that men snore more than women, although women can be predisposed after menopause.
Nasal and sinus problems: There are people who only snore when they have an allergy or sinus infection. Other known nose-related causes include nasal polyps and deviated septum (a structural condition that separates one nostril from another).
Smoking/ Alcohol consumption/ Medication: Smoking can cause inflammation in the upper airway and lead to breathing obstruction. The use of sedatives or alcohol relaxes the muscles and also narrows the airway.
Sleep posture: If you snore because your tongue is falling backwards towards your throat and obstructing your airway, you may greatly improve your snoring condition by lying on your side. This would help to prevent the base of your tongue from collapsing into the back of your throat and obstruct breathing.
Family history: Unfortunately, both snoring and sleep apnea runs in the family, which is why your health physician will ask about your family medical history in relation to the breathing condition.
What type of snorer am I?
Before you can determine the potential solutions for your snoring issues, you must find out what kind of snorer you are. A variety of devices and therapies are available that address each of the different types of snoring problems. You can identify the type of snorer you are by taking the following simple tests:
Nasal Blockage Snorer
Close your mouth, press one nostril with your finger and breathe normally. If the other nostril collapses when you inhale, try holding it open with a cotton bud stick. Now try the same test with the other nostril. If your breathing eases when you prop the other nostril open, you are most likely a nasal sleeper. The aim of this test is to assess whether or not you have stuffed sinuses.
Prolonged nasal congestion can lead to headaches as it reduces the amount of oxygen that is supplied to your lungs. Nasal congestion increases your risk for sleep apnea.
Possible Solutions for Nasal Blockage Snorers:
Nasal strips: They work by holding your nostrils open for easier breathing.
Nasal dilators: Reduces snoring by supporting the nasal cavity and preventing it from collapsing during inspiration.
Nasal sprays: Improves Obstructive Sleep Apnea by helping to unblock the nose. Taking days or weeks to work, nasal sprays do not fully control OSA and tends to be ineffective if there is a permanent nasal blockage.
Tongue Base Snorer
Stick your tongue out and hold it gently between your teeth. Try to make a snoring sound. If it sound is markedly reduced when your tongue remains in this position, you are probably a tongue base snorer. That means that your tongue may be interfering with normal airflow when you breathe during sleep, because it is resting deep in the base of your mouth.
Possible Solution for Tongue Base Snorers:
Mandibular Advancement Device (MAD): This dental appliance works by repositioning the mandible such that it keeps your tongue from obstructing your airway during sleep. The mandible is the lowest facial bone that holds the teeth in place (lower jaw).
Oral sleep devices like the SomnoDent (a type of MAS appliance) helps to treat your breathing condition by bringing your lower jaw forward during sleep. The MAS is customised to fit your individual teeth and mouth. Consisting of a set of splints for your upper/ lower jaws, the oral device may be titrated (fine-tuned) to ensure optimum comfort and effectiveness throughout the treatment process.
At Elsternwick Sleep and Snore Clinic, you can always count on having a dentist who specialises in sleep apnea to supply and fit your Mandibular Advancement Device. Our highly trained team of dental practitioners will be able to deal with any unforeseen dental problems that may occur during the treatment phases. Following the successful fitting of the appliance, all you have to do is show up for regular checks at the dentist’s office so that our clinicians can periodically adjust your device to fit better.
Try to make a snoring sound with your mouth open. Close your mouth. If you find it difficult to snore with your mouth closed, you are most likely a mouth breather. That also means that you sleep with your mouth open. If that is the case, you should also experience dryness of mouth in the morning as mouth breathing causes the soft palate of the mouth to dry out. Mouth breathers may suffer from nasal congestion, hence resort to breathing through their mouth as an alternative.
Mouth breathers are at higher risk for infection. This is because the air you inhale during sleep bypasses your nose and upper sinuses and reaches your lungs without being filtered – the tiny hairs and substances in your nostrils act as a cleansing filter. Mouth breathers are also at higher risk of choking when sleeping. Due to the body’s effort to compensate for the lack of filtering, choking becomes a natural bodily reflex to expel the tiny particles and dust.
Possible Solution for Mouth Breathers:
Chin-up’ strips: These comfortable strips provide external support that prevents the mouth from falling open during sleep. Not only do they help to reduce snoring, ‘chin-up’ strips reduce dry mouth and sore throats by keeping the mouth closed at night.
Oral shield: An oral vestibular shield promotes breathing through the nose by effectively blocking the mouth. It is an affordable and convenient treatment for curbing the effects of mouth breathing including dry mouth and bad breath.
Mouth spray: This works by gently lubricating the vibration-prone areas of your throat to reduce snoring. It is directly administered to the soft palate in a fine mist.
Soft Palate Flutterer
If none of the abovementioned tests have helped to assess your breathing condition, it is possible that you are suffering from palatal flutter. That means the cause for your snoring is due to the vibration of your soft palate. Snorers who are not overweight tend to fall into this category.
Possible Solutions for Soft Palate Flutterers:
You may also fit into more than one categories, in which case more than one treatment method may be required. For example, some people suffer from both tongue base snoring and palatal flutter.
Possible Solutions for Multifactorial Snorers:
Mandibular Advancement Device (MAD)
Mouth and nasal spray
Other solutions to stop snoring
Besides the solutions outlined above, there are many treatment options ranging from change in lifestyle habits to surgical procedures that can help with excessive snoring issues. You can discuss the following ways of countering the effects of snoring with your health professional:
Apply medications – including steroids and/or allergy treatments
Ear, Nose, Throat (ENT) surgery
Lower or stop alcohol consumption