How to stop snoring — and when to see a doctor about dangerous nighttime breathing
- Snoring isn't just annoying — it can be a sign of a serious medical condition known as sleep apnea.
- People with sleep apnea snore because their airway is closing throughout the night, which prevents them from getting enough oxygen.
- There are strategies that can relieve snoring and mild sleep apnea, and doctors can provide more serious solutions for severe cases.
A number of factors can trigger the vibrating, buzz-saw breathing sounds that we call snoring.
Someone might snore sporadically if they're suffering from allergies or a cold, if they've been drinking, or even in some cases if they sleep on their back. A more regular snoring habit can come from chronic untreated allergies, weight gain, or a structural problem in someone's nose or throat.
Loud snoring, of course, creates discomfort for the snorer and dismay for anyone who happens to share a room with them. But snoring can sometimes be a more serious problem — it's one of the primary symptoms of a common medical condition called sleep apnea.
In a person with sleep apnea, their airway closes often enough to impede the flow of oxygen to their body and brain. That's difficult to live with on a day-to-day basis, as it ruins sleep. It also increases risk for cardiovascular problems like strokes and heart attacks, as well as a number of chronic medical conditions including diabetes and high blood pressure.
"Snoring can be dangerous," Dr Karen Lee, an assistant professor of neurology at NYU Langone, told Business Insider. Lee specialises in sleep medicine and treats patients with sleep apnea and a number of other conditions at NYU's Sleep Institute.
She added: "Often my patients are sleeping in separate beds [from their partners] by the time they come in."
Snoring is the word we use to describe the sound air makes as it travels through a turbulent or collapsing pathway in the upper airway, according to Lee. The sound can be triggered by collapsing anywhere from the mouth or tip of the nose down the throat.
Since sickness, inflammation, tonsils, allergies, and more can all make a person snore, there are a number of approaches to managing the condition.
If nasal congestion or a deviated septum are causing the snoring, Lee said nasal strips or nose cones that open nasal passages can alleviate the problem. If allergies are involved, a neti pot rinse can relieve some of the trouble. In other cases, an over-the-counter nasal spray like Flonase may help, though Lee said patients should talk to their doctor before starting regular use of any medication.
For some people, sleeping flat on their back is enough to make the airway collapse, especially if they've gained weight. In cases like that when snoring has to do with body position, Lee said some people can elevate the upper part of their bed or sleep on top of wedged pillows to slightly raise the top of their body and relieve some pressure on the airway. Others can just sleep on their sides — some people even sew a tennis ball into the back of a t-shirt to make sure they never settle on their back.
Behavioural changes can make a difference too. Since weight gain can put pressure on the airway, sleep specialists advise some patients to lose weight to reduce problems with snoring. Alcohol relaxes the airway too, so if a doctor thinks drinking might be causing snoring, they may suggest cutting back.
Finally, some people snore simply because of the structure of their airway. Lee said people who snore for these reasons often have a snore-prone parent who shares their facial (and presumably airway) structure.
Assessing the problem
If someone's airway collapses at least five times in an hour (which often triggers that snoring sound), it qualifies as obstructive sleep apnea and should be treated, Lee said. Anyone regularly experiencing nighttime breathing troubles should be assessed for sleep apnea.
The National Sleep Foundation estimates that 5-20% of adults have some degree of obstructive sleep apnea, which is the most common form of the condition and involves the airway collapsing. (There is another rare form in which the brain doesn't send the signals telling the body to breathe.) But experts say sleep apnea is under-diagnosed and that some surveys have found symptoms in up to a third of adults.
The gold-standard test to see if someone has sleep apnea is an overnight sleep study in a clinic. Researchers record the sounds made in a person's throat as they sleep (since some people don't know they snore) and track the patient's brain waves to assess how they're sleeping.
But it can be difficult to get an appointment for an in-house sleep study, and insurance companies aren't always willing to cover those appointments. So many people first do a home sleep study, using recording equipment that a doctor sends home with a patient. These tests can accurately assess sleep apnea, but they sometimes underestimate the degree to which a person's breathing is limited and might miss mild cases, Lee said.
Treating sleep apnea
If a person does have sleep apnea, a more aggressive treatment may be necessary.
For some people, a dental oral appliance — a device that looks like a mouthguard — can propels the lower jaw forward and open up the airway sufficiently. But some patients experience jaw or bite alignment issues with these devices, according to Lee.
The primary treatment for severe cases relies on a continuous positive airway pressure or CPAP machine: a device that forces air pressure through a mask into a person's airway. It provides enough air pressure to keep the airway open throughout the night.
Not every patient needs a device like the CPAP at the start, according to Lee. But she cautions that sleep apnea is a progressive disease that tends to get more serious as people get older. As we age, "everything tends to sag a bit more," she explained, and that's true inside your airway, too. A patient who can use milder treatments for a while might still eventually need a CPAP.
Treatments for sleep apnea can also help people who snore chronically, even if that snoring doesn't actually limit the oxygen getting into their system.
While some of these steps might seem like extreme, research about the benefits of a good night's sleep suggests that anything you can to ensure quality rest is probably worthwhile.
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