Snoring: Treatment, symptoms, advice & help
Snoring also called sleep disordered breathing is the sound produced by vibration of the soft palate and uvula due to obstructed air movement during breathing while asleep.
Snoring: Incidence, age and sex
2 – 4 % of the middle-aged population worldwide suffer or have this condition. The problem is twice as common in males.
Signs & symptoms of snoring: Diagnosis
Usually, snoring is recognized by a friend or family member who observes the patient sleeping. A sleep study can identify conditions such as sleep apnea which may be associated with snoring. Patients can also assess their own condition to determine the likelihood of such problems based on the severity of their sleeping difficulties.
Causes and prevention of snoring
The problem results from recurrent occlusion of the pharynx during sleep usually at the level of the soft palate. During wakefulness, upper airway dilating muscles contract actively during wakefulness maintaining upper airway patency. During sleep, muscle tone declines and the ability of the upper airway dilating muscles to maintain pharyngeal patency falls. In most people sufficient tone persists to result in uncompromised breathing during sleep. A combination of an anatomically narrow palato-pharynx and underactivity of the dilating muscle during sleep results in obstruction of the airway. The turbulent flow and vibration occur, resulting in snoring.
Predisposing factors include being male, probably due to a testosterone effect on the upper airway, and obesity because parapharyngeal fat deposits tend to narrow the throat. Nasal obstruction or a recessed mandible can further exacerbate the problem. Acromegaly and hypothyroidism also predispose individuals to the condition by causing submucosal infiltration and narrowing of the upper airway. Alcohol and sedative predispose to snoring and apnoeas by relaxing the upper airway dilating muscles.
Due to the ensuing sleep fragmentation patients experience day time sleepiness, especially in monotonous situations, and this result in an increased risk of road traffic accidents. It may also increase the risk of hypertension, stroke, pulmonary hypertension and death.
Treatment: In some avoiding alcohol and weight loss will reduce the symptoms but most need to use continuous positive airway pressure (CPAP) delivered by a nasal mask every night at home. CPAP keeps the throat open by keeping the upper airway pressure above atmospheric. The effect is often dramatic and CPAP results in improvements in symptoms, daytime performance, quality of life and survival. Mandibular advancement devices worn within the mouth are an alternative approach which is effective in some patients.