Snoring is a sleep disorder when the air passing through the narrowed airways vibrates, causing a characteristic noise. Treatment options include lifestyle changes, anti-snoring mouthpieces, positive airway pressure machines (CPAP, APAP, or BiPAP), and surgery.
While a person sleeps, tissues and muscles relax and sag, causing snoring. It is also called ronchopathy. ENT doctors distinguish between quiet (up to 25 decibels) and loud (40 to 90 decibels) snoring. For example, a humming refrigerator makes sounds up to 30 dB, a passing motorcycle has 80 dB, and a train has 90 dB.
According to the German Society for Sleep Research and Sleep Medicine, the occurrence of snoring depends on age and gender. The highest prevalence is observed in middle and older age. Approximately 25-30% of people around the world snore regularly. Data shows that males are more prone to this disorder. However, snoring can also occur in childhood.
Doctors determine several types of snoring:
- Primary (simple) snoring is harmless. Interestingly, patients do not notice it. The quality of sleep is not affected.
- Apneic snoring or obstructive sleep apnea (shortly, OSA) is characterised by periods of interruption of breathing for several seconds (apnea). The airways close due to sagging palate muscles. As a result, a patient does not receive air. Such conditions can last from a few seconds to two minutes. Up to 400 sleep apnea attacks can occur in one night.
Individuals with sleep apnea are often tired and less productive during the day. The human body is exposed to a lack of oxygen during snoring. As a rule, the brain reacts sharply and makes you wake up. This type is dangerous, as it can have serious health consequences such as an increased risk of heart attack, stroke and depression; it also may cause headaches or gastrointestinal problems.
Snoring can undoubtedly arise as a sign of ageing, as muscles and tissues lose strength. In addition, it can be aggravated by alcohol or certain medications (hypnotics, antihistamines). The sleeping position also affects snoring. For instance, humans who sleep on their backs are more likely to snore.
What is the cause of snoring?
Muscle elasticity decreases during sleep, tongue drops, and airflow reduce, provoking vibration and typical snoring sounds.
In children, enlarged pharyngeal and palatine tonsils are the most common cause. For adults, the problem is more complex. Some medical disorders might increase the risk of snoring:
- Common cold;
- Rhinitis (runny nose);
- Nasal polyps;
- Tonsils enlargement;
- Nasal deformity (curvature of the nasal septum);
- Anatomical mouth features, such as altered jaw proportions or an enlarged tongue.
In addition, various factors affect snoring:
- Use of alcohol or drugs;
- Taking sleeping pills or sedatives;
- Sleep in the supine position.
Symptoms of snoring
Simple snoring is unlikely to cause complaints in patients. However, in such cases, relatives of patients get much more discomfort.
Apneic snoring can cause the following symptoms:
- Difficulty falling asleep;
- Morning headaches;
- Dry mouth;
- Daytime sleepiness.
A partner may notice the following signs in a snoring patient: pauses in breathing during sleep and awakening with sudden shortness of breath. In addition, due to disturbed sleep, patients experience chronic fatigue, irritability, and decreased concentration.
How do doctors diagnose snoring?
Primarily, otorhinolaryngologists conduct a conversation and take a medical history with the patient and his partner to get complaints and a description of the disease.
Next, physicians examine the upper airways for harmful changes. Then, an endoscopy (tube with a camera) examines the inside of the nostril to determine if there is an abnormal septum or a deviated nose. Also, endoscopic methods help determine the function of nasal breathing. These methods include rhinomanometry and rhinoresistometry.
As imaging modalities, x-rays, computed tomography (CT), and magnetic resonance imaging (MRI) are helpful. Otorhinolaryngologists also use additional diagnostic methods: digital volumetric and panoramic tomography, to get a detailed picture of the jaws.
If obstructive sleep apnea is suspected, doctors prescribe polysomnography. A patient spends the night in the clinic to measure heart rate, breathing rate, blood oxygen levels, sleep stages and leg movements with sleep sensors attached to the head and body.
What treatment is available for snoring?
Depending on the causes and nature of snoring disorders, ENT doctors use various types of therapy. Treatment options include lifestyle changes, anti-snoring mouthpieces, oral exercises, automatic positive airway pressure (CPAP, APAP, or BiPAP) devices, and surgery.
An anti-snoring mouthpiece is an intraoral device that helps keep the tongue or jaw stable so that it doesn't block the airway during sleeping. Snoring splints compress the throat tissues and push the lower jaw forward. As a result, muscles remain stable, and airways open while a person sleeps.
CPAP therapy delivers pressurised air through a mask. As a result, sleep is normalised, and blood pressure and body weight are stabilised.
BiPAP therapy is effective for patients with complicated snoring and severe forms of obstructive sleep apnea. Respiratory BiPAP allows patients to restore respiratory function during sleep, preventing severe complications and significantly improving the quality of life. BiPAP is a breathing apparatus with an automatic compressor and an electronic system. The device helps the patient to inhale.
Surgery can eliminate nasal blockages (polyps, deviated septum). Doctors recommend surgical treatment for uncomplicated snoring and mild to moderate obstructive sleep apnea syndrome. Possible operation types:
- Correction of the nasal septum;
- Endoscopic polypectomy - polyps removal;
- Tonsillectomy is the removal of excess soft palate tissue that vibrates during sleep and generates snoring;
- Plastic surgery of the soft palate (its expansion or partial removal).
What can patients with snoring expect?
Primary snoring has a favourable prognosis. It does not harm health and practically does not reduce the quality of life. However, loud snoring often provokes discomfort to a partner or neighbours. Nevertheless, the forecast for apneic snoring is satisfactory, providing timely treatment and avoiding complications.
How can I treat snoring?
First of all, lifestyle change is an essential step in treating snoring. It usually helps. When it is ineffective, mouth splints and mouthpieces constrain snoring. Physicians may recommend surgery to treat the reason for the disease.
Can I go for snoring surgery abroad?
Yes. It is better to undergo snoring surgery abroad. Foreign clinics and sleep centres are supplied with the necessary modern equipment and have many years of experience treating such conditions.
Is the nose issue causing snoring?
Yes. Nasal issues such as polyps or a deviated septum cause snoring. Also, diseases provoke it (sinusitis, rhinitis, colds).
Why is a snoring treatment abroad better?
The healthcare system abroad is better organised. For example, you do not have to wait long to undergo examinations. In addition, there are special clinics specialising in sleep quality and problems, including snoring.
What are doctors responsible for snoring treatment?
ENT doctors (ear, nose, throat) specialise in snoring treatment. These physicians are also called otorhinolaryngologists. Sometimes ENT surgeons help in solving the problem.