02.What causes snoring plus sleep apneoa
What casues snoring?
Snoring occurs when there’s any kind of collapse, blockage or restriction to the upper airway that hinders the flow of air through the back of the mouth or nose.
The snoring sound is created by the vibration of the soft tissues at the back of the throat. You may snore intermittently or frequently for a number of reasons:
- You’ve got a cold.
- You’ve been drinking alcohol, which causes the tongue and muscles in the throat to relax.
- You’re overweight. Overweight people have extra bulk around the neck that can restrict their airways. Being overweight is the most common cause of persistent snoring. There’s also experimental evidence that abdominal fat pushes the chest up towards the upper airway, which then loses its tension, becoming floppy.
- You’ve got an enlarged tongue, uvula, tonsils or adenoids.
- You take sleeping pills or muscle relaxants.
- You have nasal congestion or a bent septum (the wall that separates the nostrils).
- You have an illness such as hypothyroidism or a disease affecting the central nervous system.
- You have sleep apnoea.
- Finally, some people only snore when they’re lying on their back.
If your snoring is accompanied by pauses, snorts and gasps for air, get referred to a sleep specialist to be tested for sleep apnoea.
Obstructive sleep apnoea (OSA) is a condition where breathing stops many times during the night.
- waking feeling unrefreshed
- daytime sleepiness
- mood swings
OSA may be caused by:
- carrying too much weight
- anatomical factors such as enlarged tonsils
- alcohol or sedative use.
Left untreated it can leave you dangerously tired, irritable, and more vulnerable to high blood pressure and coronary disease.
This usually involves a trip to a sleep lab where you’ll undergo polysomnography (tests measuring your physiological activity as you sleep).
- Weight loss.
- Avoid alcohol and sedatives.
- Nasal CPAP (continuous positive airway pressure) is thought to be the most effective non-invasive treatment for OSA. The CPAP machine has a nasal mask that blows air through the nose and holds the airway open, helping you breathe regularly through the night.
- In some cases, surgery may be suggested. The ENT specialist we consulted said surgery can be helpful but only if it’s performed on the appropriate people, such as those who aren’t overweight but have a large palate that’s causing obstruction.
- Sleep apnoea or chronic snoring may also be treated with mandibular splints — dental appliances that can move the jaw forward or stop the tongue falling backwards. Experts say the newer appliances are more comfortable than the bulky mouthguards of old, and are good for people with apnoea who can’t tolerate the CPAP machine. Mandibular splints must be prescribed by a sleep medicine or ENT specialist, who’ll then refer you to a dentist and dental technician to make and fit the device.
Tips for a silent night
If there’s no convincing evidence that any of these products is effective at reducing snoring, what can you do?
Experts say lifestyle changes are the best solution.
- If you snore because you’re overweight, get some support to help you stick to a sensible eating and exercise plan. Even moderate weight loss has been shown to reduce or stop snoring.
- Snoring is yet another good reason to quit smoking.
- Avoid sleeping pills, tranquillisers and muscle relaxants, and don’t drink alcohol at least four hours before going to bed.
- If you only snore when sleeping on your back, train yourself to sleep on your side. (Wedging a pillow behind your back, or the old trick of sewing a tennis ball onto the back of your pyjama top, might work for you.
A happy ending…
One of our ‘guinea-pig’ couples, Ruth and Ivan, reported back that they’d followed advice on lifestyle changes with considerable success. Ivan had lost some weight and, with the help of Ruth’s gentle (and not-so gentle) prodding, had trained himself to sleep on his side.
Ruth was very happy to say that over the last few months, Ivan’s snoring has improved remarkably. It’s rarely loud enough to wake her. When it does, it’s because he’s lying on his back. She gently nudges Ivan and he rolls over immediately — and the snoring ceases.
This article last reviewed April 2006