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Snoring: A symptom not a disease, what can be done?

Men's Health, Sleep Disorders, Age related illnesses, General | July 22, 2014 | Author: The Super Pharmacist

sleep, ENT

Snoring: A symptom not a disease, what can be done?

Snoring is quite common. Some estimates suggest every third man and every fourth woman snores to some degree. And it only gets more frequent with age. Snoring may be mild and harmless, but it can also have serious implications for the snorer’s health and for those around whose sleep is being disturbed.

How is the Snoring sound produced?

Sound as we all know is air waves set into motion by a vibrating structure. We also know that when the smooth streamline flow of air is disrupted, it creates turbulence. This will cause nearby structures to vibrate and produce sound. This happens in the throat when there is abnormal airflow due to obstruction. The structure that most commonly vibrates is the soft palate.

Causes of SnoringCauses of Snoring

As the mechanism of snoring outlined above indicates, it requires a certain degree of airway obstruction. This obstruction can be at the level of the nose in the form of nasal polyps or a deviated nasal septum, or it can be at the level of the throat due to a thick neck, obesity, palate problems or a tongue falling back. In children it could be adenoids or tonsils. When the cause is nasal, snoring will occur in the presence of mouth breathing. Otherwise mouth breathing does not always accompany snoring.

Possible effects of Snoring:

  • Disturbed sleep
  • Dry throat
  • Morning headache
  • Daytime sleepiness
  • Fatigue
  • Concentration and attention problems
  • Mood irritability

A special effect of snoring to consider is how it can strain a relationship with your sleep partner. This can happen in a number of ways. Disturbed sleep can reduce daytime freshness and activity levels for you both, sleeping in separate rooms decreases physical intimacy and the irritable mood that comes along with deprived sleep can trigger unnecessary squabbles. Some studies suggest that snoring, sleep apnoea and inadequate sleep can decrease libido which will directly affect a relationship. All this indicates that seeking a solution to your snoring problem is not only good for your health, it is good for a healthy relationship.

Snoring Risk Factors

  • Male gender
  • Overweight
  • Sedatives
  • Alcohol
  • Advanced age

Diagnosing snoring

In your quest to identify and grade your snoring issue, your partner’s contribution is essential. In fact people will typically get to know they snore by sleep partners.

Diagnosing snoringSince you snore only when you are asleep, it is hard to make a self-diagnosis, unless you record your sleep. Your sleep partner can help you keep a sleep diary which can be a good initial investigation into your sleep hygiene.

If you think you have more than just mild snoring and if you feel you experience some of the symptoms mentioned above, it is recommended that you consult with your primary care doctor. Your doctor will need a history and an examination. He/she can then order further investigations or refer you to an otolaryngologist (ENT doctor) or a sleep consultant. 

The gold standard investigation for snoring and sleep apnoea is a sleep study. The medical term is polysomnography. It requires an overnight stay at the sleep clinic. 
A briefer version of the sleep study can be conducted at home with gadgets and instructions provided to you. 

The home sleep study can give some good clues but a full scale polysomnogram may still be required. A distinction has to be made here.

While most cases of obstructive sleep apnoea snore, everyone who snores does not have obstructive sleep apnoea.

Treatment Options

Home remedies and Lifestyle changes

  • Weight loss is essential for overweight people, so much so that significant weight reduction of itself may cure the condition.
  • Quit smoking
  • Quit alcohol especially before bedtime.
  • Quit sedatives
  • Regular exercise tones up your body muscles. This holds true for your airway muscles as well so they don’t collapse and you don’t snore.
  • Regular sleep patterns
  • Sleep on your side

Medicinal management

CPAP stands for Continuous Positive Airway Pressure. This is a novel way of keeping your airways open.

Snoring Risk FactorsA device sends air at a certain pressure into your airways via tubing and a mask that covers your nose and mouth. This prevents the airways from collapsing. This not only relieves snoring, it also treats the more ominous obstructive sleep apnoea. Introduced in 1980 by an Australian physician Dr. Colin Sullivan, CPAP it is now considered the treatment of choice for obstructive sleep apnoea and intractable snoring.

Decongestants such as pseudoephedrine help relieve nasal obstruction. Special consideration should be made about limiting the regular use of these medications to avoid rebound sinus issues and those who suffer from cardiovascular issues such as hypertension.

Dental devices come in different forms. They may be expensive and cumbersome to wear but they are the cure for some snorers.

Role of Surgery

A variety of surgical procedures and techniques have been devised to help people with potentially harmful snoring and sleep apnoea. We highlight some of the more common procedures:

Pillar procedure in which synthetic strips are placed in the soft palate that make it stiffer so that there is a decreased chance for it to vibrate or collapse, thereby alleviating snoring and sleep apnoea.

Radiofrequency ablation gets rid of excessive tissue in the throat and widens the airway.

UPPP or UvuloPalatoPharyngoPlasty is surgery that removes unwanted tissue from the soft palate and throat in an attempt to widen the airway. It is more invasive than radiofrequency ablation.

Septoplasty is nasal surgery for a deviated nasal septum that causes obstruction.

Polypectomy is nasal surgery for removal of nasal polyps that cause obstruction.

Tonsillectomy is the surgical removal of tonsils, which are a cause of airway narrowing more commonly in children.

Adenoidectomy is the surgical removal of adenoids, which are a cause of airway narrowing more commonly in children.

Alternative Approaches

Singing

Thisis an enjoyable way to strengthen your airway muscles. As someone observed, singers rarely snore.

Didgeridoo playing

The digeridoo is an Australian indigenous musical wind instrument which is gaining popularity across the globe. Some studies suggest that practising the didgeridoo on a regular basis can strengthen the airway muscles enough to cure mild to moderate snoring.

Throat exercises

These specifically aim to enhance the intrinsic tone of airway musculature. Various workouts have been developed for different groups of airway muscles.

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References

Barnes ME, Huss EA, Garrod KN, et al. Impairments in attention in occasionally snoring children: An event-related potential study. Dev Neuropsychol. 2009;34(5):629–649.

Riemann R, Volk R, Müller A, Herzog M. The influence of nocturnal alcohol ingestion on snoring. Eur Arch Otorhinolaryngol. 2010;267:1147–1156.

Patil SP, Schneider H, Schwartz AR, Smith PL. Adult obstructive sleep apnea: pathophysiology and diagnosis. Chest 132: 325–337, 2007.

Hukins CA. Obstructive sleep apnea-management update. Neuropsychiatric disease and treatment.2006;2(3):309–26.

Friedman M, Vidyasagar R, Bliznikas D, et al. Patient selection and efficacy of pillar implant technique for treatment of snoring and obstructive sleep apnea/hypopnea syndrome. Otolaryngol Head Neck Surg.2006;134:187–196.

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