Chronic Snoring Guide
We’ve all heard someone snoring, whether it’s a partner, a parent, or a stranger sitting next to us on an airplane. Snoring, or noisy breathing during sleep, can take on many different sounds and styles, but in any of its forms, it can be disruptive and potentially a problem for the sleeper and for others around them who are also trying to sleep. This is especially true for chronic snoring, which represents ongoing and persistent snoring.
Snoring is common among adults in the United States. The Sleep Foundation estimates that around 90 million people snore, and of those, about 37 million snore regularly.
While we all know snoring when we hear it, we may not know the more in-depth details about how and why it happens, its potential implications, and how it can be addressed. This guide covers all of these details and more to help people who snore and the people who share a bed with them.
What Causes Snoring?
At a basic physiological level, snoring is caused by a narrowing of the airway in the throat. Just like whistling happens by pushing air through a narrowed airway formed by the lips, snoring happens as air is forced through this narrowed airway, vibrating the soft tissue in the throat.
This narrowing of the airway can happen for a number of reasons. Primarily, snoring happens when we sleep because the muscles and soft tissue near the airway relax, leaving less room for air to move through.
Many different things can increase the likelihood of this airway narrowing, and these are known as risk factors. These are some of the most well-established risk factors for snoring:
- Being overweight: people who are overweight often have more soft tissue in the back of the throat, reducing airflow. Being overweight can also contribute to sleep apnea, which causes chronic snoring (see the section on Sleep Apnea below for more information).
- Being older: as we enter old age, the muscles and tissue in the throat often become softer and more relaxed, which can contribute to snoring.
- Nasal congestion: if your nose is congested, your lungs have to work more and push more air through your throat, creating more vibrations and snoring.
- Nasal deformity: as with nasal congestion, having a nasal deformity like a deviated septum can increase the risk of snoring.
- Swollen or large mouth anatomy: if your soft palate, tongue, or uvula are larger, or if you have swollen tonsils, then the airway may be restricted and snoring may be more likely.
- Being pregnant: tissue in the throat may swell during pregnancy, especially later during the second and third trimesters. This swelling can restrict airflow and lead to snoring.
- Drinking alcohol: because alcohol can cause the throat muscles to relax even more than normal, drinking tends to exacerbate snoring. The impact of this is likely to be enhanced the closer to bedtime that you drink.
- Taking sedative medications: as with alcohol, these medications can accelerate relaxation of muscles near the airway.
- Sleeping on your back: people who sleep in this position are more prone to snoring because gravity causes the airway to naturally be less open.
As you reflect on this list, remember that having a risk factor for chronic snoring does not mean that you will definitely suffer from this problem. Having a risk factor only means that you are more likely to have issues with chronic snoring.
What are the Health Implications of Snoring?
In most cases, chronic snoring is a not a severe health issue. Generally, the biggest health threat related to snoring is in people who snore because of sleep apnea (discussed in more detail in the following section). That said, even in people who do not have sleep apnea, regular snoring can still be a problem.
Snoring may be a nuisance both to people who snore and to their partner. Also, some studies have found that people who snore do not get as restful of a night’s sleep. This may contribute to feeling sleepier and less alert during the day.
What is Sleep Apnea?
Obstructive sleep apnea (OSA), which is often more generally referred to as sleep apnea (though there are other types of sleep apnea, too), is a condition in which the narrowing or blocking of the airway causes a person’s breathing to temporarily stop while sleeping. OSA is the most serious health issue when it comes to chronic snoring.
It is important to state clearly that not everyone who snores has sleep apnea. But virtually all people with sleep apnea have issues with chronic snoring. The snoring associated with OSA tends to be very loud and disruptive.
Sleep apnea is associated a number of potentially serious health effects if untreated. These include excessive daytime sleepiness (which can raise risks of auto accidents, falls, or other injuries), depression, and cardiovascular issues (including high blood pressure, heart attack, and stroke).
Many of the risk factors for chronic snoring are similar to the risk factors for OSA. OSA can also be hereditary. The most common treatments for OSA include lifestyle changes (such as losing weight, sleeping on one’s side, and reducing alcohol intake), use of a continuous positive airway pressure (CPAP) device to help keep the airway open, and in some cases surgery.
If you think you may have OSA, it is critical to consult with a doctor. Talk to your doctor if you find that you are suffering from significant and regular daytime sleepiness, if you have pronounced snoring at night that wakes you up, and especially if your partner notices you gasping for air during the night. Your doctor can review your sleeping habits and if necessary, prescribe tests that can help evaluate your breathing during sleep.
How Can Snoring be Stopped or Reduced?
If you are dealing with chronic snoring, there are a number of steps that you can take to try to address this problem. We break these options down into three main categories — behavior, products, and surgery. Each is described in further detail below.
Some of the most straightforward ways to reduce snoring involve behavior changes. While certain changes may be easier than others, each of these can help to reduce the risk of chronic snoring.
- Maintaining a healthy weight: carrying excess weight can increase the risk for snoring, and even minor weight loss may be able to help reduce how much you snore.
- Reduce alcohol consumption: decreasing the amount that you drink, especially before bed, can help prevent the relaxing of throat muscles that contributes to snoring.
- Avoid other sedatives: like alcohol, other sedative medications can contribute to snoring, so avoid taking these whenever possible.
- Don’t sleep on your back: though it can be difficult to change your sleeping position, it can be remarkably helpful for reducing snoring. If you can make this switch, most experts recommend sleeping on your side.
Behavior changes are most likely to be successful for people who have mild snoring or mild sleep apnea. If you have more severe sleep apnea or snoring or if it persists despite behavior modifications, other treatments may be needed.
Many different products are on the market to try to help with snoring. Keep in mind that just because something is advertised as an anti-snoring product doesn’t mean that it’s necessarily been proven to be effective in rigorous studies. It is always advisable to talk with your doctor before taking any new medication or beginning to use any medical device.
- Dental devices: one way to help try to keep the airway open is by trying to keep the jaw forward in your mouth. Dental devices, also called anti-snoring mouthpieces, can be custom-fitted by a dentist for your mouth. For many people, they are more comfortable than CPAP machines and as a result, may be preferred and used at a higher rate.
- CPAP machines: as mentioned in the section on sleep apnea, CPAP machines are designed to help keep the airway open through the night. When using a CPAP, you wear a mask that is connected to a machine that generates airflow through the mask. Having to wear the mask for the CPAP machine can be an uncomfortable change for many people. However, newer masks are generally lighter and easier to wear, so most people adjust to them within a couple of weeks.
- Special pillows: certain pillows are marketed as anti-snoring pillows, and they work by trying to keep the airway aligned and open. These pillows come in different sizes and designs based on your sleeping position and may try to help keep your chin away from the chest (if you are a back sleeper) or keep your jaw forward (if you are a side sleeper).
- Special sleepwear: some sleepwear is designed in order to prevent you from being able to sleep on your back. Examples include belts that have inflatable sections near the lower back or shirts with tennis ball sized lumps sewn into the back of them. Both of these are intended to make it very uncomfortable if you try to roll onto your back.
Products to Reduce Nasal Congestion
Because nasal congestion can contribute to snoring, some products focus specifically on reducing this congestion. These products include:
- Nasal strips: these are placed on the bridge of the nose and can help widen the nasal passages.
- Nasal decongestants: these help to reduce mucus in the nose, although it is important to be wary of ones that contain antihistamines or other sedatives.
- Nose vents: these products are placed into the nose with the goal of keeping the nostrils widened and more open for air to pass through.
- Air purifiers: these are most likely to be helpful for people with allergies as an air purifier may help to reduce allergy-related congestion.
Though surgery is rarely the first line of treatment for chronic snoring, it may be considered if snoring is persistent or if it is clearly attributable to an anatomical issue. Surgeries for snoring are typically designed to reduce or remove the tissue that can block the airway. It is important to remember, though, that no surgery is 100% effective, and that some of these procedures may not completely eliminate snoring or the need for behavioral changes. Examples of some of the surgeries used to address snoring include:
- Uvulopalatopharyngoplasty: this surgery has a long name and as a result may be abbreviated as UPPP or UP3. In this surgery, the uvula and some of the soft tissue nearby are removed. If only the uvula is removed, it is known as an uvuloplasty.
- Somnoplasty: this surgery removes throat tissue. It may be done in several ways including the use of heat or through agents that cause scarring and eventual shrinking of the tissue.
- Tonsillectomy: if a person still has their tonsils, they can be removed through a tonsillectomy. This is most likely to be considered for people who have recurring infections that cause the tonsils to be regularly swollen in ways that can obstruct the airway.
- Septoplasty: this surgery focuses on the nasal passages and can be used to correct a deviated septum or similar issues that may obstruct airflow through the nose.
- Bariatric surgery: this surgery is normally associated with addressing obesity, but studies have found that it can also have a positive impact on OSA. Bariatric surgery, also known as gastric bypass, works by making your stomach smaller and by altering how your gastrointestinal system handles the food that you eat.
Remember that every surgery has potential benefits and risks. If you are a possible candidate for surgery, you can expect to consult with an ear, nose, and throat doctor (ENT or otolaryngologist). The doctor can review the nature of the surgery, potential complications, general success rates, whether any hospital stay would be required, whether you would need to miss work, and the overall recovery timeline. If you have concerns about surgery, you can always get a second opinion by meeting with a second ear, nose, and throat specialist.
What Can You do if Your Partner Snores?
One of the biggest implications of snoring is on whoever shares the bed or bedroom with the person who snores. While the person who is snoring may be able to just keep on sleeping, a partner is often disrupted when trying to fall asleep or may be awoken in the night because of loud snoring.
The single most important thing that you can do as a partner of someone with a chronic snoring problem is to begin to communicate about it in an honest and sensitive way. Your partner needs to know about how their snoring is affecting you, but because many people don’t even realize the extent of their snoring, they may be quick to take offense or feel criticized when the issue comes up. As we outlined in this guide, there are steps that can be taken to try to reduce their snoring, and if it’s enough to regularly diminish your sleep, then your partner should make sure to bring it up with their doctor.
If your partner’s snoring cannot be completely eliminated by behavior change, products, or surgery, you can turn to other approaches for relief. Some of the things that may help include:
- White noise machine: these compact devices create a low-level background noise that can help to soften other sounds. If you would prefer not to invest in a machine, you can also look into smartphone apps that provide white noise or other types of background noises that may help you turn your focus away from your partner’s snoring.
- Relaxation exercises: focusing on your breathing and other techniques for meditation and relaxation can help calm your mind and body and may be able to reduce how much your partner’s snoring affects you. These techniques can be useful right before trying to go to sleep, and they can also help if you wake up in the middle of the night and are trying to fall back asleep.
- Earplugs: these cheap, simple devices can go a long way because they can very effectively block out noise around you. Make sure to look for a pair that is comfortable and that fits well enough so that they will stay in your ears if you move around in your sleep.