A: Snoring happens when the muscles in the tongue, roof of your mouth and throat relax and constrict airflow. “You can’t get a full breath of air, so things start vibrating as they try to allow you to breathe — and the vibration is the snoring sound,” said Dr Kent Smith, a sleep dentist in Dallas and former president of the American Sleep and Breathing Academy.
Men are about twice as likely to snore as women are, and it can be caused by a number of things, including allergies, ageing, a cold or even just the distinctive shape of your throat. Your weight might also play a role.
“You’ve got this combination of tissues that over time, when you gain weight, they gain weight,” Smith said. “And when you get older, they become a little less toned. So they just tend to clog the airway.”
Excessively dry or wet air can aggravate snoring, as can sleeping at a high altitude. Sleeping on your back or drinking alcohol before bed tends to make it worse, further relaxing the muscles and allowing the tongue to close the throat and restrict air.
Still, snoring itself is not a disorder, no matter what your sleeping partner might say. But sometimes it can be a sign of sleep apnoea, a potentially serious condition that causes breathing to repeatedly stop and start throughout the night, preventing you from getting a decent night’s rest. It can also raise the risk of high blood pressure and even heart failure.
While loud snoring is usually associated with sleep apnoea, plenty of mild snorers have no health problems at all. It’s just one part of a spectrum of disordered sleeping, ranging from those who snore to those for whom the triggers of snoring cause them to lose sleep, said Dr Jolie Chang, an otolaryngologist at the University of California, San Francisco.
“Most people with sleep apnoea snore,” she said, “but snoring alone does not mean you have sleep apnoea.”
If you are not sure if you snore, it’s easy to find out. Download a recording app, such as SnoreLab, to your phone and run it while you sleep. The app will start recording when it detects noises, and the next morning you can listen to your own sonorous tones.
Once you know you are a snorer, even a subtle one, it might be worthwhile to get a sleep test from a sleep clinic, Smith said. Most of the time, the first one can be done at home in one night and will tell you if your snoring is a symptom of a larger problem, like sleep apnoea, based on how many times per hour it interrupts your sleep.
WHAT CAN YOU DO IF YOUR SNORING IS MILD?
A mild snorer might make noise at night, but still get plenty of air, with the snoring only occasionally interrupting sleep. Whether or not your occasional wood sawing is tied to wider problems, there are steps you can take to lower the night noise.
Sleep on your side. About half of snorers with sleep apnoea in one Israeli study were found to stop when they changed positions. There are pillows available to help you sleep on your side and shirts that make it uncomfortable to roll on your back. For the DIY-types, you can try sewing some tennis balls onto the back of your night shirt.
Strengthen your tongue. One of the most common causes of snoring is when your tongue slides back in your throat. The simplest way to prevent this is with a daily set of tongue exercises. But Chang said it can take weeks to have an effect and most people are not diligent in keeping them up.
There are also a steady stream of anti-snoring devices available to buy online, most totally worthless. Chin straps, nose clips and strips, nostril dilators — be wary of them, Chang said, they don’t work for everyone. A humidifier might help you sleep better by moisturising your nose and throat, she added, but it probably can’t stop your snoring.
WHAT IF YOUR SNORING IS MODERATE?
If your sleep study suggests your snoring is moderate — that the lack of air is interrupting your sleep more than 15 times per hour — you should see a sleep doctor, pulmonologist or ear, nose and throat specialist. They might recommend the following:
CPAP (continuous positive airway pressure) machine. This is a device that attaches to either your nose or your nose and mouth to increase the amount of air getting past your throat.
Mouth guard. A mouth guard helps to position the jaw a little bit forward so that the tongue cannot creep down the throat and block it. It’s more convenient than a tube strapped to your face, but it requires a skilled dentist and multiple visits to tailor it to your teeth and jaw. Be sure that your insurance will cover it, and avoid cheaper, over-the-counter guards, because they won’t work unless they are calibrated correctly.
Weight loss. Another way for some people to decrease snoring is to lose weight. Body mass index is reliably connected to snoring and sleep apnoea, Chang said, though every throat is different. Losing weight will decrease the pressure on your windpipe and allow more air to pass.
WHAT SHOULD YOU DO IF YOU’RE A SEVERE SNORER?
The chances are very high that extremely loud snorers are having some form of apnoea. If a sleep test indicates that your snoring is affecting your sleep more than 30 times per hour you might be looking at more serious problems down the line, such as heart disease and all the issues that accompany insufficient sleep, like depression and anxiety.
CPAP machine. At this point, don’t bother with the mouth guard, Smith said. “When you get into the severe ranges of apnoea, then CPAP is more predictable to solve your problem,” he said. CPAP devices come in dozens of designs, some of which are not too intrusive. But all require you to sleep with something covering part of your face that connects to a softly whirring machine.
Surgery. A range of surgical procedures — involving implants or changes to the tongue or soft palate — can help a severe snorer, but only if CPAPs fail. “If you can’t do those or for whatever reason you don’t want to,” Smith said, “then surgery should be last. You should never jump to that first.”
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