Sep
11
2007

What a snore: How do you stop those sounds in the night?

Snore no more: This Mayo Clinic diagram shows the lay of the land of the body parts in your head that contribute to snoring. (Diagram from MayoClinic.com)
Snore no more: This Mayo Clinic diagram shows the lay of the land of the body parts in your head that contribute to snoring. (Diagram from MayoClinic.com)
Last summer’s post on how to stop the hiccups is still generating reader comments. Last night I saw an ad for a commercial product to help stop chronic snoring. It got me to thinking to bring up the topic in this forum to find your tricks to overcoming this noisy and nosy problem.

First a couple quick facts:

• Forty-five percent of normal adults snore at least occasionally, and 25 percent, or about 55 million Americans, are habitual snorers. Problem snoring is more frequent in males and overweight people, and it usually worsens with age.

• More than 300 devices are registered in the U.S. Patent and Trademark Office as cures for snoring.

And here’s some snoring data courtesy of MayoClinic.com.

Snoring occurs when air flows past relaxed tissues in your throat, causing the tissues to vibrate as you breathe, creating hoarse or harsh sounds. As you doze off and progress from a lighter sleep to a deep sleep, the muscles in the roof of your mouth, tongue and throat relax. If the tissues in your throat relax enough, they vibrate and may partially obstruct your airway. The more narrowed your airway, the more forceful the airflow becomes. As tissue vibration increases, your snoring grows louder.

What contributes to snoring
• Mouth anatomy. Having a low, thick soft palate or enlarged tonsils or tissues in the back of your throat can narrow your airway. Likewise, if the uvula is elongated, airflow can be obstructed and vibration increases. Being overweight contributes to narrowing of your airway.
• Alcohol consumption. Snoring also can be brought on by consuming too much alcohol before bedtime. Alcohol acts as a sedative, relaxing throat muscles.
• Nasal problems. Chronic nasal congestion or a crooked partition between your nostrils (deviated nasal septum) may be to blame.
• Sleep apnea. Snoring may also be associated with obstructive sleep apnea. In this serious condition, your throat tissues obstruct your airway, preventing you from breathing. Sleep apnea is characterized by loud snoring followed by periods of silence that can last 10 seconds or more. Eventually, the lack of oxygen and an increase in carbon dioxide signal you to wake up, forcing your airway open with a loud snort or gasping sound.

Treatments
• Oral appliances. Oral appliances are form-fitting dental mouthpieces that help advance the position of your tongue and soft palate to keep your air passage open.
• Traditional surgery. You're given general anesthesia and your surgeon tightens and trims excess tissues -- a type of face-lift for your throat.
• Laser surgery. In an outpatient surgery, your doctor uses a small hand-held laser beam to shorten the soft palate and remove your uvula. You may need more than one session to get your snoring under control. Laser surgery isn't advised for occasional or light snoring, but it's an option if your snoring is loud and disruptive.
• Radio frequency tissue. Doctors use a low-intensity radio frequency signal to remove part of the soft palate to reduce snoring. It's an outpatient procedure performed using local anesthesia.
• Continuous positive airway pressure. This approach involves wearing a pressurized mask over your nose while you sleep. The mask is attached to a small pump that forces air through your airway, which keeps it open.

To prevent or quiet snoring, try these tips:
• If you're overweight, lose weight. Being overweight is a common cause of snoring. Loose throat tissues are more likely to vibrate as you breathe, and extra bulkiness in the throat narrows your airway.
• Sleep on your side. Lying on your back allows your tongue to fall backward into your throat, narrowing your airway and partially obstructing airflow. To prevent sleeping on your back, try sewing a tennis ball in the back of your pajama top.
• Nasal strips. Adhesive strips applied to your nose help many people increase the area of their nasal passage, enhancing their breathing.
• Treat nasal congestion or obstruction. Having a deviated septum or allergies can limit airflow through your nose. This forces you to breathe through your mouth, increasing the likelihood of snoring.
• Limit or avoid alcohol and sedatives. Avoid drinking alcohol at least four hours before bedtime, and let your doctor know about your snoring before taking sedatives or hypnotics. Sedatives and hypnotics (sleeping pills) and alcohol depress your central nervous system, causing excessive relaxation of muscles.

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Your Comments, Thoughts, Questions, Ideas

mdr's picture
mdr says:

I suffer from sleep apnea and for a while used a CPAP (Continuous Positive Airway Pressure) machine to treat it. Other users I talked to swore by the device, but I never really liked using the old “nose hose”. It was a pain being attached to a tube while sleeping, and traveling with it was a whole ‘nuther issue. After a year or so I lost some weight and my apnea seemed to diminish, so I happily put the machine away.

My weight loss, not surprisingly, was temporary and soon the apnea reappeared. Not only was I not getting any deep sleep, but my snoring and snorting and gasping for breath was affecting my wife's slumber, so something needed to be done. By then my CPAP machine was missing parts, covered in dust, and pretty much unusable from sitting on the closet floor.

One day I heard a radio report about a dentist in St. Louis Park, Minnesota, who was treating sleep apnea using an adjustable oral appliance that fits over the patient’s teeth, and keeps their jaw jutted forward, thus effectively keeping their air passage open while they sleep.

I met with him for a consultation, and decided to try it. And I have to say I couldn't be happier. The appliance is tailored to each individual's mouth and is adjustable so that the optimum treatment can take place. The only down side, if it can be called that, is that you need to readjust your bite each morning by clamping down on a plastic “leaf blade” for a while. I’ve been using it for nearly a year now, and it’s been working just great. It’s easy to travel with, simple to maintain, and my wife and I are both getting a decent night’s sleep again.

posted on Thu, 09/13/2007 - 10:13am
Liza's picture
Liza says:

I'm always amazed at how many people suffer from sleep apnea and snoring, and how many folks I know use those continuous positive airway pressure masks. Frankly, I don't know how anyone sleeps with one of those on.

Back in July, I came across a MedPage Today article proposing a different, way-more-comfortable-sounding method for increasing airway pressure: a nasal cannula, instead of a mask, that delivers warmed, humidified air. (What's a nasal cannula?) It's a device to deliver oxygen via two little prongs that fit in your nose.)

Probably doesn't travel as nicely as your mouthguard, Mark, but if you need positive airway control, it's gotta beat the gas mask...

posted on Wed, 09/12/2007 - 12:41pm
Daisy's picture
Daisy says:

When sleeping with one of those masks on is the only way an otherwise severely sleep-deprived person *can* sleep, she learns to love it.

The nasal cannula probably doesn't have sufficient pressure to keep the airways open for those with sleep apnea.

posted on Wed, 09/12/2007 - 2:44pm
Liza's picture
Liza says:

Daisy,

I forgot to add a link to the original story when I posted yesterday. (I've added it now.)

The study cited in MedPageToday was small--only 11 participants--but the results showed that use of the cannula significantly reduced the number of apnea "events" per night--even for folks with obstructive sleep apnea.

It probably doesn't work for everyone, but the CPAP masks have a low "adherence rate." (That is, people try them, and then stop using them.) If you need airway pressure, and you just can't bear the mask, this might be a solution.

posted on Thu, 09/13/2007 - 10:19am
mdr's picture
mdr says:

Thanks Liza. The nasal cannula would probably be an improvement but it'd still be connected by hoses to a machine which was one of my major complaints. When I would toss and turn during sleep, the hose would snag on things and sometimes the whole mask would be pulled off.

posted on Wed, 09/12/2007 - 2:57pm
jackinTokyo's picture
jackinTokyo says:

I have tried a sleep apnoea mask for a month,here in Japan,where I teach. I am in great physical condition,working out in the gym and swimming three or four times a week, despite getting on in years. I went to this Japanese doctor, known as a respiratory expert. After a test at home for three nights, with a meter attached to my wrist,middle finger and a hose up my nostrils, he prescribed a sleep apnoea machine with mask. I wanted to stop snoring, that my Japanese wife politely prevents by gently moving me off my back. I opine that this sleeping on my back is the main source of the trouble. I wanted further opinion from the doctor because I have been so so tired of late and thought my interrupted sleep was the main cause. It looks like I am set up for life with a monstrous cumbersome machine and I am looking for a good reason to ditch it. It occurs to me that the doctor has ignored the main reason for my snoring - sleeping on my back. I will go to him again and ask for the testing to be carried out again(wrist meter,hose up nose etc.) but this time I will use a tennis ball on back technique to keep me off my back. I shudder at the idea that I might have to use this monstrosity for the rest of my life.
What think you, other forum members?
John

posted on Sat, 06/19/2010 - 10:35pm

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