Snoring - adults

Answer 1

DefinitionSnoring is a loud, hoarse, or harsh breathing sound that occurs during sleep. Considerations

Snoring is common in adults. It does not necessarily mean that you have a health problem.

A doctor (or sleep specialist) can tell if you have sleep apnea by doing a sleep study either at home or in a hospital.

Snoring is an important social problem. People who share a bed with someone who snores can develop sleep difficulties.

Common Causes

In most people, the reason for snoring is not known. Some possible causes include:

• Being overweight -- the extra neck tissue puts pressure on the airways
• Swelling of the tissue during the last month of pregnancy
• Blockage in the nose caused by a crooked, bent, or deformed nasal septum (the structure that separates the nostrils)
• Nasal polyps
• Stuffed nose from a cold or Allergies, especially if it lasts a long time

Changes in the mouth and throat, such as:

• Swelling in the roof of the mouth (soft palate) or the uvula, the piece of tissue that hangs down in the back of the mouth. These areas may also be longer than normal.
• Swollen adenoids and tonsils that block the airways
• Poor muscle tone
• A large area at the base of the tongue, or a tongue that is large compared to the mouth
• Abnormalities in the bones of the face
• Use of sleeping pills, antihistamines, or alcohol at bedtime

Sometimes snoring can be a sign of a sleep disorder called sleep apnea. This means you have periods in which you completely or partly stop breathing for more than 10 seconds while you sleep.

The episode is followed by a sudden snort or gasp when you start breathing again. Then you start to snore again. If you have sleep apnea, this cycle usually happens many times a night. Sleep apnea is not as common as snoring.

Home Care

The following tips may help reduce snoring:

• Avoid alcohol and other sedatives at bedtime.
• Don't sleep flat on your back. Sleep on your side, if possible. Some doctors even suggest sewing a Golf or tennis ball into the back of your night clothes. This causes discomfort if you roll over and helps reminds you to stay on your side. Eventually, sleeping on your side becomes a habit and you don't need to be reminded.
• Lose weight, if you are overweight.
• Try over-the-counter, drug-free nasal strips that help widen the nostrils. (These are not treatments for sleep apnea.)

If your doctor has given you a breathing device, use it on a regular basis. Follow your health care provider's advice for treating allergy symptoms.

Call your health care provider if

Talk to your health care provider if you have:

• A change in your level of attention, concentration, or memory
• Been waking up in the morning not feeling rested
• Episodes of no breathing (apnea) -- your partner may need to tell you if you are snoring loudly or making choking and gasping sounds
• Excessive daytime drowsiness
• Morning headaches
• Recent weight gain

Children with chronic snoring should also be tested for apnea. Sleep apnea in children has been linked to growth problems, ADHD, poor school performance, learning difficulties, bedwetting, and high blood pressure. Most children who snore do NOT have apnea, but a sleep study is the only way to tell for sure.

What to expect at your health care provider's office

Your health care provider will ask questions to evaluate your snoring. You will also have a physical exam that focuses on your throat, mouth, and neck.

Questions may include the following (some of which your partner might have to answer):

• Is your snoring loud?
• Do you snore no matter what position you are lying in, or only in certain positions?
• Does your own snoring ever wake you up?
• How often do you snore? Every night?
• Do you snore throughout the night?
• Are there episodes when you are not breathing?
• Do you have other symptoms like daytime drowsiness, morning headaches, insomnia, or memory loss?

You may need to be referred to a sleep specialist for sleep studies.

Treatment options include:

• Dental appliances to prevent your tongue from falling back
• Weight loss
• If you have sleep apnea, use of a CPAP mask (a device you wear on the nose while sleeping to decrease snoring and sleep apnea)
• Surgical procedures on your palate
• Surgery to correct a deviated septum or remove tonsils (tonsillectomy)
• Other types of surgery involving the airway

References

Franklin KA, Anttila H, Axelsson S, Gislason T, Maasilta P, Myhre KI, et al. Effects and side-effects of surgery for snoring and obstructive sleep apnea--a systematic review. Sleep. 2009;32:27-36.

Friedman M, Schalch P. Surgery of the palate and oropharynx. Otolaryngol Clin North Am. 2007 Aug;40(4):829-43.

Patil SP, Schneider H, Schwartz AR, Smith PL. Adult obstructive sleep apnea: pathophysiology and diagnosis. Chest. 2007 Jul;132(1):325-37.

Basner RC. Continuous positive airway pressure for obstructive sleep apnea. N Engl J Med. 2007 Apr 26;356(17):1751-8.

Reviewed By

Review Date: 08/31/2011

Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.