What is snoring?

Snoring is a harsh sound produced by vibration of the soft tissues of the upper airway during sleep. It usually occurs during breathing in, but can also occur during breathing out. Habitual snoring is common, more common in males than females and increases with increasing age. Occasional snoring is almost universal

What is the difference between snoring and sleep apnea (OSA)?

Snoring can be a symptom of obstructive sleep apnea (OSA)but not everyone who snores has the sleep disorder. Obstructive sleep apnea is a serious sleep disorder that causes you to temporarily stop breathing when you are asleep.

Why do I snore?

• Obesity, Pregnancy and Genetic Factors-Extra tissue in the throat can vibrate as you breathe in air in your sleep, causing you to snore.
• Allergies, Congestion and Certain Nasal Structures-Anything that prevents you from breathing through your nose can cause you to snore.
• Alcohol, smoking, aging and certain drugs and medications, including muscle relaxants-You may snore when your throat or tongue muscles are relaxed.

What are the symptoms of snoring?

The primary symptom of snoring is unmistakable – the often loud, harsh or coarse noises that you make while you are asleep. Other symptoms may include waking up with a sore throat or dry mouth.

If you have any of the following symptoms you may have sleep apnea:

• Excessive daytime sleepiness
• Choking or gasping while you sleep
• Pauses in breathing
• Morning headaches
• Difficulty concentrating
• Moodiness, irritability or depression
• Frequent need to urinate during the night

Are there any tests for snoring?

The ENT doctor might recommend any other following:

• Sleep endoscopy (passing camera down your throat),
• Imaging like xray or MRI
• Home sleep apnea test (HSAT). The HSAT allows you to sleep at home wearing equipment that collects information about how you breathe during sleep. You will usually set up the testing equipment yourself.

What are the treatment options?

Conservative measures

• Weight loss-if your BMI is above 30 or collar size is above size 17 in men and 16 in women, loss of weight coupled with an exercise regime will
• Tobacco and alcohol-these can cause your tongue and throat muscles to relax; avoid tobacco or alcohol for at least 4 hours before bed.
• Sleep position-risk of snoring is higher when you sleep on your back rather than your side. A simple device that can be made at home is a snug-fitting T-shirt with a pocket sewn over the spine and tennis balls placed in the pocket.

Nasal patency

• Nasal decongestants-the nose is the narrowest part of the airways. Nasal congestion can impair airflow through the nose. We suggest that individuals who snore only during a common cold receive a trial of decongestant therapy before bedtime during colds
• Intranasal steroids-nasal congestion from allergic rhinitis (nasal allergies) or chronic sinusitis may improve on intranasal steroids.
• Nasal dilators-these are devices that aim to open up the front of the nose which is the narrowest part of the airway.

Mechanical approaches

• Oral appliances-Oral appliances fit in your mouth or over your teeth while you sleep and increase the size of the upper airway, which decreases snoring. They are indicated to treat snoring when conservative therapies have failed or are inappropriate for the individual patient. OA typically work by advancing the lower jaw, changing the position of the roof of the mouth or pulling forward the tongue. They are fitted by a dentist.
• CPAP- CPAP therapy keeps your airway open during the night by gently providing a constant stream of air through a mask you wear while you sleep.

Surgical options

• UPPP-This is the most common surgery to reduce or eliminate the bulky tissue in your throat.
• Palatal implants-this procedure stiffens the roof of your mouth making it less floppy.
• Dental surgery-this aim at adjusting the bony structures.
• Nasal surgery-correction of a deviated nasal septum, enlarged nasal turbinates or nasal polyps improve airflow through the nose.

Disclaimer

The content on the Nairobi ENT website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions.

References

1. Kushida, Clete A., et al. “Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances: an update for 2005.” Sleep2 (2006): 240-243.
2. Force, A.O.S.A.T, and American Academy of Sleep Medicine. “Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults.” Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine3 (2009): 263.
3. Aurora, R. Nisha, et al. “Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults.” Sleep10 (2010): 1408-1413.