Does Snoring Have You Up All Night?

The snoring treatments you’ve been waiting for

From the WebMD Archives

Every night the same ritual plays out in Nancy Rothstein’s bedroom. She goes to sleep before her husband does, and then, a few hours later, she’s awakened by the grating sound of his snoring. “I usually lie there for a while and try to decide whether I have the energy to move to another room,” she says. “I’ve tried earplugs, which are uncomfortable, so most nights I end up playing musical beds. Some nights it’s just simpler to start out in a different room, so I can get a good night’s sleep.”

Multiply that scenario by a few million, and you’ll get a sense of what’s going on in couples’ bedrooms all over the country. According to the National Sleep Foundation, snoring affects 90 million adults, 37 million of them on a regular basis. And while men are twice as likely as women to snore among younger folk, that gap closes after menopause, and women snore in equal numbers.

A poll conducted by the sleep foundation in 2005 found that sleep problems—most commonly snoring—not only have an impact on how well you sleep but can negatively affect relationships between bed partners. The snoring situation is so dire, in fact, that more and more newly constructed homes are being built with two master bedrooms, or small “snoring rooms” for the offender. That may sound extreme, but only to someone who hasn’t been serenaded in the wee hours by the maddening multiple frequencies and breathing inconsistencies that constitute snoring—unlike white noise, which is constant and far less disturbing.

Banishing your bed partner to another room, however, isn’t always a sound approach (no pun intended). A better solution would, of course, be a cure for snoring, because snoring can be a sign of more serious health problems that require treatment.

What causes snoring?

To no one’s surprise, the largest group of run-of-the-mill snorers is middle-aged and older men. But snoring is more common than most people realize—30% of adults over the age of 30 snore—and women make up one-third of those snorers. Benign snoring, as it’s called, is caused by “upper airway turbulence” that leads to vibrations of the soft palate and the uvula (that little flap that hangs down at the back of the throat), explains Joseph Scianna, MD, co-director of Loyola University Health System’s Nasal Sinus Center.

When you think about it, that snoring increases with age makes sense. As we age we lose muscle tone everywhere, including in our palates, which become flabby and thus more susceptible to vibration. Allergies or being overweight can also contribute to snoring. Drinking alcohol before bedtime, which relaxes the muscles in the airway, is another potential cause. Or you may simply have been born to snore. “Some people have larger tongues or palates than others, or thick necks or a weak glossopharygeal nerve (which helps control the tongue), says Ralph Pascualy, MD, medical director of the Swedish Sleep Medicine Institute in Seattle. “It’s often many factors that interact in different ways.”

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When is snoring a serious sleep problem?

Snoring has been fodder for humorists for centuries, inspiring images of clueless oafs who generate noises loud enough to lift the roof or wake people in neighboring counties. But it’s really not that funny to be kept awake all night, and it’s even less amusing when the noise is a sign of a serious health problem, known as obstructive sleep apnea (OSA). OSA is a disorder in which breathing repeatedly stops for brief periods during sleep because the throat muscles can’t keep the airway consistently open. This leads to fragmented sleep and lowers oxygen levels in the blood, which in turn puts people at risk for cardiovascular problems such as hypertension and heart disease, not to mention daytime fatigue. The National Sleep Foundation estimates that 18 million people suffer from OSA, the majority of them undiagnosed.

Since snorers rarely wake themselves, their bed partners play a critical role in making sure they get help. Therefore, leaving the room, or kicking your partner out of bed, is a bad idea, because then no one can monitor the nature of the snoring, points out Rothstein, whose personal struggle with her snoring husband inspired her to write a children’s book on the topic, My Daddy Snores (Scholastic, 2006). In fact, “Most of our patients are men who are brought in by their wives,” says Scianna.

“If a woman observes that her husband is snorting, gasping or puffing, or if his snoring isn’t steady but goes up and down in volume, he should be evaluated for sleep apnea,” says Pascualy. (Likewise, if your bed partner notices these symptoms in you, you should be evaluated.) Most primary care physicians don’t routinely ask about sleep habits, so it’s important to bring the topic up yourself and get a referral to a sleep specialist, if necessary.

Is there a cure for snoring and obstructive sleep apnea?

Fortunately, many treatments exist to help snorers and those with obstructive sleep apnea. Not all work for everyone, but through trial and error and consultation with a physician, you might find one of these cures for snoring works for you.

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Snoring Cure No. 1: Make lifestyle changes

Snoring has been linked to being both overweight and out of shape, so working on those two issues can have the payoff of improving your sleep. Losing weight and exercising more improve muscle tone, even in your palate, says Scianna. Avoiding alcohol before bedtime may help too.

For some people, the problem is purely positional, meaning they only snore when lying on their backs. If this is the case for you, you might find that arranging your pillows creatively keeps you on your side. (Some people even resort to wearing a special shirt with a pocket in the back to hold a tennis ball that pokes them when they try to roll over onto their backs.)

Snoring Cure No. 2: Try over-the-counter remedies

If allergies or nasal congestion seem to be the cause of snoring, an antihistamine or decongestant might be all you need to breathe freely and sleep comfortably. Antisnoring strips and sprays exist, but Pascualy says they haven’t been found to be particularly effective.

Snoring Cure No. 3: Use oral devices

Dental appliances that hold the tongue and jaw in such a way that the airway remains open have been found to be quite effective for benign snorers, with success rates ranging from 50%–80%. They can also be effective for OSA, although at lower rates of success (40%–50%). What’s key, say experts, is to have one custom-made by a dentist, rather than buying an over-the-counter version or one from the Internet.

Snoring Cure No. 4: Try continuous positive airway pressure, or CPAP

Continuous positive airway pressure (CPAP) is the leading therapy for sleep apnea. The CPAP device consists of a mask worn over the nose and face during sleep, which is connected to a pump that pushes air into the nasal passages, keeping the airway open. Compliance is a problem, though. The treatment only works if you use the mask regularly, and some people find it uncomfortable, or are self-conscious about wearing it in front of their partner.

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Snoring Cure No. 5: Elect to have surgery

As a last resort, there are several surgical procedures doctors can perform to increase the size of your airways. In some cases it’s just a matter of fixing a structural problem such as a deviated septum or removing adenoids. Other techniques include placing implants in the palate, which stimulate the formation of scar tissue and reduce snoring, or removing the uvula. Both of these procedures have a success rate of around 50%, though the long-term benefits are not yet known.

WebMD Feature Reviewed by Louise Chang, MD on November 19, 2008

Sources

SOURCES: Joseph Scianna, MD, co-director of Loyola University Health System’s Nasal Sinus Center. Ralph Pascualy, MD, medical director of the Swedish Sleep Medicine Institute. Nancy Rothstein, The Vancouver Sleep and Breathing Centre; www.mydaddysnores.com. National Sleep Foundation web site. American Sleep Apnea Association website.

© 2007 WebMD, Inc. All rights reserved.

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