Snoring is the sound produced while someone is sleeping. It occurs due to blockage of partial blockage of the air passages and resulting vibration of the respiratory structures. Snoring may be the first sign of obstructive sleep apnea. It is an important social problem and even may affect relationship with the partner. The most common causes include obesity, blockage of the nasal pathway due to polyp or deviation of the nasal septum.
Snoring leads to number of complications like interrupted sleep in the night leading to daytime sleepiness, difficulty in concentrating and behavior problems. Obese alcoholic men are at more risk of snoring. Treatment options include lifestyle modification, using implants and surgery to correct any underlying nasal deformity.
Snoring usually presents with :
- Noisy sleep.
- Increased daytime sleepiness.
- Interrupted sleep in the night
- Poor concentration.
- Deterioration of performance at work place, increased risk of motor vehicle accident.
- High blood pressure, chest pain, increased risk of brain damage and stroke.
- Behavioral changes like frustration, depression, anger, aggression and learning problems.
- Interruption of others during sleep.
During sleeping when a person drifts from lighter to deeper sleep, the muscles of the roof of the mouth (soft palate), tongue and tissue of the throat become relaxed. These relaxed tissues may block the airways partially. The air pressure increases considerably in case of narrow airways and leads to vibration of the surrounding tissues and subsequent snoring. Depending upon the extent of the blockage of the airway and pressure of the air, snoring can be soft or loud.
There are number of factors which may lead to narrowing of airways and therefore snoring. These are :
- Having a thick soft plate placed at a lower position in the mouth narrows the airway considerably. Obese people have extra neck fat tissue which is likely to narrow the airway. Similarly a longer uvula, the piece of tissue hanging from the soft palate at the back of the mouth, may obstruct the airway.
- Alcohol relaxes the neck muscles to a greater degree and facilitates obstruction of the airway.
- Nasal problem such as a large polyp, deviated nasal septum that divides the nasal cavity into two halves or suffering from nasal congestion for prolonged periods due to the common cold increases the chance of snoring.
- Snoring is often associated with sleep apnea where the patient suddenly wakes up from sleep in the night because of sudden stoppage of breathing either due to complete blockage of the airways or due to impaired signaling from the brain to the breathing muscles.
- Sleeping on one’s back where the tongue may block the airways partially.
- Faulty positioning of the jaw may lead to narrowing of airways.
Vibration generated during snoring may increases the turbulence of blood flow through the carotid artery. As a result there is increased chance of fatty deposits (atherosclerosis) on the wall of the carotid artery leading to increased risk of stroke and brain damage.
Common risk factors are :
- Family history of snoring
- Nasal defect
- Narrow airways
Treatment options include :
- Lifestyle changes like reducing weight, avoiding alcohol and changing sleeping posture.
- Using oral appliances and palatal implants.
- Surgery to correct the nasal problem and to shrink the soft palate using radiofrequency.