SNORING – How and Why?
Nearly 45% of normal adults snore occasionally, and atleast 25 % are habitual snorers. The problem is more in overweight persons (males) and it worsens with advancing age. Many devices are registered all over the world as cures for snoring. Some are variations on the old idea of sewing a sock that holds a tennis ball on the pajama back to force the snorer to sleep on his side. (It is often worse when a person sleeps on his back). Some devices reposition the lower jaw forward, some open nasal air passages, a few others have been designed to condition a person not to snore by producing unpleasant stimuli when snoring occurs. The fact is snoring is not under Volutional control and if anti-snoring devices work, it is probably because they keep the snorer awake or sleep in the sideways position.
Is it dangerous :
When there is no loss of sleep at night and no symptoms of excess sleep In day time then snoring is a SOCIAL PROBLEM. If the sleep is disturbed and daytime somnambulance is present then it is a DANGEROUS MEDICAL PROBLEM.
Causes of Snoring:
The noisy sound of snoring occurs when there is an obstruction to the free flow of air through the passages at the back of the mouth and nose. This area is the collapsible part of the airway where the tongue and upper throat meet the soft palate and uvula. This occurs when these structures strike each other and vibrate during breathing.
Patients who snore may suffer from:
Poor muscle tone in the tongue and throat. When muscles are too relaxed, either from alcohol or drugs that cause sleepiness, the tongue falls backwards into the airway or the throat muscles draw in from the sides into the airway. This can also happen during deep sleep.
- Excessive bulkiness of throat tissue. Children with large tonsils and adenoids often snore. Overweight people have bulky neck tissue. Cysts or tumors also cause bulk, but they are rare.
- Long soft palate and/or uvula. A long palate narrows the opening from the nose into the throat. As it dangles, it acts as a noisy flutter valve during relaxed breathing. A long uvula makes matters even worse.
- Obstructed nasal airways. A stuffy or blocked nose requires extra effort to pull air through it. This creates an exaggerated vacuum in the throat, and pulls together the floppy tissues of the throat, and snoring results. In some snoring often occurs only during the hay fever season or with a cold or sinus infection.
Deformities of the nose or nasal septum, such as a deviated septum (a deformity of the wall that separates one nostril from the other) cause an obstruction.
Is Snoring Serious?
Yes! It is serious, when it makes the snorer an object of ridicule and causes others sleepless nights and resentfulness.
Medically – yes! It disturbs sleeping patterns and deprives the snorer of appropriate rest. When snoring is severe, it causes serious long-term health problems including obstructive sleep apnea.
When loud snoring is interrupted by frequent episodes of totally obstructed breathing, it is known as obstructive sleep apnea. Serious episodes last more than ten seconds each and occur more than seven times per hour. Apnea patients may experience 30 to 300 such events per night. These episodes reduce blood oxygen levels, causing the heart to pump harder.
The sudden effect of sleep apnea is that the snorer must sleep lightly and keep his muscles tense in order to keep airflow to the lungs. Because the snorer does not get a good rest, he may be sleepy during the day, which impairs job performance and makes him a hazardous driver or equipment operator. After many years with this disorder, elevated blood pressure and heart enlargement may occur.
Can Heavy Snoring be Cured?
Heavy snorers, who snore in any position or disruptive to the family, should seek medical advice to ensure that sleep apnea is ruled out. An otolaryngologist will provide a thorough examination of the nose, mouth, throat, palate, and neck. A study in a laboratory environment may be necessary to determine how serious the snoring is and what effects it has on the snorer’s health.
Treatment depends on the diagnosis. An examination will reveal if the snoring is caused by nasal allergy, infection, deformity, or tonsils and adenoids.Snoring or obstructive sleep apnea may respond to various treatments now offered by many otolaryngologist-head and neck surgeons:
- Uvulopalatopharyngoplasty (UPPP) is surgery for treating obstructive sleep apnea. It tightens flabby tissues in the throat and palate, and expands air passages.
- Thermal Ablation Palatoplasty (TAP) refers to procedures and techniques that treat snoring and some of them also are used to treat various severities of obstructive sleep apnea. Different types of TAP include bipolar cautery, laser, and radio frequency.
- Laser Assisted Uvula Palatoplasty (LAUP) treats snoring and mild obstructive sleep apnea by removing the obstruction in the airway. A laser is used to vaporize the uvula and a specified portion of the palate in a series of small procedures in a doctor’s office under local anesthesia.
- Radio frequency ablation-some with temperature control approved by the FDA-utilizes a needle electrode to emit energy to shrink excess tissue of the upper airway including the palate and uvula (for snoring), base of the tongue (for obstructive sleep apnea), and nasal turbinates (for chronic nasal obstruction).
- Genioglossus and hyoid advancement is a procedure for the treatment of sleep apnea. It prevents collapse of the lower throat and pulls the tongue muscles forward, thereby opening the obstructed airway.
If surgery is too risky or unwanted, the patient may sleep every night with a nasal mask that delivers air pressure into the throat; this is called continuous positive airway pressure or “CPAP”.
A chronically snoring child should be examined for problems with his or her tonsils and adenoids. A tonsillectomy and adenoidectomy may be required to return the child to full health.
Self-Help for the Light Snorer
Adults who suffer from mild or occasional snoring should try the following self-help remedies:
- Adopt a healthy and athletic lifestyle to develop good muscle tone and lose weight.
- Avoid tranquilizers, sleeping pills, and antihistamines before bedtime.
- Avoid alcohol for at least four hours and heavy meals or snacks for three hours before retiring.
- Establish regular sleeping patterns
- Sleep on your side rather than your back.
- Tilt the head of the bed upward four inches.
Remember that snoring means obstructed breathing, and obstruction can be serious. It’s not funny, and not hopeless.