Why do people snore?
About half of people snore at some point during their lives. Snoring is more common in men, and the incidence of snoring increases as you get older. Snoring is the sound of turbulent airflow and vibrations of the soft tissue in the back of your throat and palate. This sound occurs because of air flowing through narrowed passages in the back of the nose, throat, or palate.
While snoring can be bothersome to others, it can also be a symptom of a more serious medical condition called obstructive sleep apnea. Sleep apnea is a relatively common condition affecting an estimated 25 million adults, with many cases going completely undiagnosed.
With sleep apnea, the upper airway repeatedly becomes narrowed or completely blocked, causing you to stop breathing. When this happens, it limits the amount of air and oxygen, reaching your lungs, heart, brain, and other vital organs. This blockage most commonly occurs in the collapsible part of the upper airway, where the tongue and upper throat meet the soft palate and uvula. The narrowing or collapse can occur when the muscles of your throat relax when you sleep, especially if you sleep on your back.
Other factors that can contribute to snoring and sleep apnea include narrowing of the throat related to an enlarged tongue, tonsils or adenoids, an excessively long palate or uvula, or natural variations in a person’s anatomy. Being overweight is one of the most significant risk factors for sleep apnea. Nasal congestion from a deviated septum, enlarged nasal turbinates, sinus problems, allergies, or a cold can lead to mouth breathing, which may also increase the risk of snoring.
You may also snore when your throat or tongue muscles become overly relaxed because of the use of alcohol, muscle relaxants, or sleep medication, as well as the effects of natural aging.
What are the symptoms of sleep apnea?
The most common symptom of sleep apnea is loud snoring. Sleep apnea is characterized by multiple pauses in breathing that can last more than 10 seconds at a time due to the narrowing or collapse of the upper airway. The snoring is often interrupted by gasping or choking sounds as you try to breathe. This can lead to significant disruption of normal sleep patterns and cause excessive daytime tiredness.
Without proper treatment, obstructive sleep apnea is associated with an increased risk of high blood pressure, stroke, and heart disease. Excessive sleepiness from sleep apnea has also been associated with impaired workplace functioning and is associated with an increased risk of motor vehicle accidents.
Many people who have sleep apnea have not been evaluated or treated.
Common symptoms of sleep apnea include:
- Loud snoring
- Pauses in breathing
- Choking or gasping sounds
- Daytime sleepiness
- Morning dry or sore throat
- Morning headache
- Memory loss
- Difficulty concentrating
How is sleep apnea diagnosed?
Dr. Loft will begin your snoring and sleep apnea evaluation with a thorough history and physical examination, including fiberoptic evaluation of your upper airway, to identify any potential anatomic narrowing. If sleep apnea is suspected, an overnight sleep study (polysomnogram) will be ordered. This overnight recording will monitor your sleep, breathing, and oxygen to determine if you have sleep apnea.
This study can be performed either in a dedicated sleep center or often in the convenience and privacy of your own home with a portable monitor.
How is sleep apnea treated?
Dr. Loft will recommend a personalized treatment plan based on the patient's sleep history, physical examination, and the results of the sleep study.
For snoring without sleep apnea, initial conservative nonsurgical options are preferred. These may include weight loss, sleep positioning modifications, avoidance of nighttime alcohol and sedatives, or the use of an oral appliance to be worn at bedtime.
Minimally invasive office-based procedures, including radiofrequency reduction of the nasal turbinates, soft palate, and uvula, may be considered if more conservative measures are unsuccessful in controlling the snoring.
For patients with sleep apnea, the most effective therapy is continuous positive airway pressure, also known as CPAP. This treatment delivers a small amount of continuous pressure through an appliance that is worn over the nose or mouth during sleep. CPAP is currently the treatment of choice for patients with significant sleep apnea, but its use is sometimes limited by patient compliance and comfort. In overweight patients, weight loss is an essential part of sleep apnea therapy and can often significantly reduce the severity of the apnea. For patients unable to tolerate CPAP therapy, surgical widening of the upper airway with uvulopalatopharyngoplasty (UPPP) and more recent hypoglossal nerve stimulator implants may be recommended.
If you are concerned about snoring or sleep apnea and would like an experienced otolaryngologist to assess and treat your condition properly, call Lloyd Loft, MD, FACS or make an appointment online today.
