Is Snoring Bad?
Snoring is a common condition that affects roughly 57% of men and 40% of women (1). Light snoring may not be disruptive, but heavy or loud snoring can lead to sleep loss and other issues in both the snorer and their sleep partner.
Studies have shown our tendency to snore increases with age, and that overweight or obese people (2) are also more vulnerable. Other risk factors include consumption of alcohol and other sedatives before bed, pregnancy, and structures that impede airflow in the breathing passages, such as abnormally large tonsils or a deviated nasal septum.
While snoring is not inherently bad or dangerous, heavy snoring is considered a warning sign for the disorder known as sleep apnea. Different treatment options are available for people who chronically snore.
What Causes Snoring?
Snoring occurs when a person’s breathing is blocked or restricted, creating vibrations in the soft palate and other tissues of the nasopharynx that produce audible noises. Some experts argue loss of muscle tone (3) during sleep plays a role in why we snore — otherwise people would also snore while they are awake, since the dimensions of their nasopharyngeal structures don’t change between sleep and wakefulness.
Some snoring — called primary snoring (4) — doesn’t wake up sleepers, hinder airflow through the lungs, or decrease oxygen levels. In most cases, primary snoring doesn’t directly cause excessive daytime sleepiness. Snoring can also be a symptom of obstructive sleep apnea (OSA) and other types of sleep-disordered breathing.
Risk factors for primary snoring or sleep-disordered breathing include:
- Body Weight: People who are overweight or obese are more likely to snore. The connection between weight and snoring can be attributed to excess tissue in the neck (5) restricting the breathing passages.
- Age: Snoring is more common in people over 50.
- Sex: While snoring is common among both sexes, men are more likely to snore than women.
- Sleep Position: Studies have shown the supine (back) sleeping position can restrict more airflow compared to the side or stomach positions.
- Alcohol and Other Sedatives: Consuming alcoholic beverages or taking sedative medications before bed can cause the tongue and throat muscles to become overly relaxed. Airflow can easily be impeded when the tongue falls into the back of the throat, leading to snoring.
- Pregnancy: Pregnant women often experience tissue swelling during their third trimester. Swelling that occurs around the neck or throat can restrict breathing. Postmenopausal women are also considered at higher risk for snoring.
- Head and Neck Structures: Some people snore due to the shape of the structures around the breathing passages. Examples include a small or recessed jaw, enlarged tonsils, a large tongue or soft palate (the roof of the mouth), a deviated nasal septum (an asymmetrical wall between the nostrils), and nasal polyps (a growth in the nostril or sinuses).
Snoring and Obstructive Sleep Apnea
Snoring is considered a chief symptom of obstructive sleep apnea (OSA) (6). While not everyone who snores meets the criteria for OSA, most people with OSA snore.
OSA is characterized by a physical blockage that restricts breathing and causes the individual to wake up choking or gasping for air. Apneas are choking or gasping episodes that last at least 10 seconds and cause breathing to completely pause, whereas hypopneas are episodes of shallow breathing.
The Apnea-Hypopnea Index (AHI) evaluates the severity of sleep apnea, and measures the number of episodes that occur every hour. Those with mild cases of OSA may experience five to 15 episodes per hour, while people with severe symptoms can experience more than 30 hourly episodes.
OSA can cause major sleep disruptions for not only the individual experiencing the disorder, but also their sleep partner. Regardless of severity, most people with OSA experience some level of excessive daytime sleepiness.
OSA has also been linked to a higher risk of more serious medical conditions such as high blood pressure, stroke, heart disorders, and diabetes (7). For these reasons, sleepers who are concerned about their snoring should see a doctor about being evaluated for OSA.
When Should You See a Doctor About Snoring?
In addition to heavy snoring and apnea or hypopnea episodes, symptoms associated with OSA include:
- Headaches that occur in the morning
- Daytime sleepiness or grogginess
- High blood pressure
If you snore and experience any of these symptoms, consider contacting your physician. Doctors often evaluate snoring by reviewing medical history, then discussing the matter with you and your sleep partner. A physical examination usually follows, during which the doctor inspects the jaw and throat for possible obstruction sources. Areas of concern during this comprehensive evaluation include snoring intensity, body-mass index, neck size, and alcohol/sedative intake before bed.
If your doctor finds evidence of OSA, they may recommend a polysomnography. This overnight test may require you to sleep in a laboratory with equipment to monitor your breathing, but some polysomnography evaluations can be conducted at home. These tests are both expensive and time-consuming, so a doctor probably won’t suggest polysomnography unless they suspect OSA.
How to Reduce Snoring
For people who snore due to OSA, continuous positive air pressure (CPAP) therapy has proven highly effective. CPAP involves a machine that draws in outside air using a fan and pressurizes it to a certain setting. After pressurization, the air is transmitted through a connective hose and into the sleeper’s nostrils and/or mouth. A specialized face mask that seals off these areas is needed to ensure proper air delivery.
CPAP therapy requires a prescription, and your doctor may conduct ongoing assessments to see if symptoms improve. CPAP therapy is normally discouraged for people who snore but haven’t received an OSA diagnosis. Other ways to reduce snoring include:
- Change Your Sleep Position: People who snore should attempt to keep their heads properly elevated throughout the night and see if changing sleep positions reduces snoring (8). If you normally sleep on your back, try switching to the side position instead. You can also place wedges beneath the legs of your bed to raise the head. Adjustable bed bases are another effective — albeit more expensive — way to make sure the head stays elevated.
- Avoid Alcohol and Other Sedatives before Bed: Abstain from alcoholic beverages and sedative medications for at least a few hours leading up to bedtime.
- Lose Weight: Many people experience less snoring after losing weight.
Anti-snoring mouthpieces may also be effective for some. These devices generally fall into one of two categories.
- Mandibular advancement devices (MADs) use a mold of your teeth to physically move the tongue and lower jaw forward to maximize airflow. Some MADs can be manually adjusted for optimal fitting. Some MADs require a prescription.
- Tongue-retaining devices (TRDs) form a seal around the tongue and use suction to keep it in place, which prevents it from falling into the back of the throat and blocking the airway. TRDs are typically “one size fits all” and don’t require any customization, but they cannot be adjusted and tend to be less comfortable than MADs.
Lastly, surgery may be needed for people who snore heavily due to abnormally large or shaped structures adjacent to the breathing passages. These procedures include surgically reshaping the uvula and soft palate, also known as uvulopalatopharyngoplasty. That said, surgical procedures are costly and often invasive, and their effectiveness should be studied further. Therefore, this type of treatment is normally reserved for extreme cases.
+ 8 Sources
- 1. Accessed on March 9, 2021.https://www.merckmanuals.com/professional/neurologic-disorders/sleep-and-wakefulness-disorders/snoring
- 2. Accessed on March 9, 2021.https://medlineplus.gov/snoring.html
- 3. Accessed on March 10, 2021.https://pubmed.ncbi.nlm.nih.gov/1671953/
- 4. Accessed on March 9, 2021.https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/sleep-disorders/snoring
- 5. Accessed on March 9, 2021.https://medlineplus.gov/ency/patientinstructions/000720.htm
- 6. Accessed on March 9, 2021.https://learn.aasm.org/Users/Catalog.aspx
- 7. Accessed on March 10, 2021.https://www.merckmanuals.com/home/lung-and-airway-disorders/sleep-apnea/sleep-apnea
- 8. Accessed on March 10, 2021.https://pubmed.ncbi.nlm.nih.gov/31888795/
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