Snoring

Snoring

Snoring is the vibration of respiratory structures and the resulting sound due to obstructed air movement during breathing while sleeping. The sound can range from soft to loud and unpleasant. Snoring during sleep may be an early indication or symptom of obstructive sleep apnea (OSA). Research suggests that snoring is one of the factors contributing to sleep deprivation.<ref name="Finkel">Finkel, K. J., Searleman, A. C., Tymkew, H., Tanaka, C. Y., Saager, L., Safer-Zadeh, E., ... & Avidan, M. S. (2009). Prevalence of undiagnosed obstructive sleep apnea among adult surgical patients in an academic medical center. Sleep Medicine, 10(7), 753-758.</ref>

Causes

Snoring occurs when the flow of air through the mouth and nose is partially blocked during sleep. This obstruction can be due to various factors, including:

• Anatomical factors: The shape and size of the airway, nasal passages, and oral cavity can influence the likelihood of snoring. Enlarged tonsils or adenoids, a deviated nasal septum, or a narrow throat can contribute to airway obstruction.
• Obesity: Excess weight, particularly around the neck, can put pressure on the airway and increase the likelihood of snoring.
• Nasal congestion: Congestion due to allergies or a cold can obstruct the nasal passages and increase the likelihood of snoring.
• Alcohol consumption: Alcohol relaxes the muscles in the throat, increasing the risk of airway obstruction and snoring.
• Sleep position: Sleeping on the back can cause the tongue and soft palate to collapse to the back of the throat, partially obstructing the airway and increasing the likelihood of snoring.

Diagnosis

Diagnosis of snoring typically involves a thorough patient history, physical examination, and possibly a sleep study, such as polysomnography, to evaluate the severity of the snoring and identify any underlying sleep disorders, such as obstructive sleep apnea.<ref name="Abrishami">Abrishami, A., Khajehdehi, A., & Chung, F. (2010). A systematic review of screening questionnaires for obstructive sleep apnea. Canadian Journal of Anesthesia/Journal Canadien d'anesthésie, 57(5), 423-438.</ref>

Treatment

Treatment options for snoring depend on the severity of the snoring and any underlying causes. Some common treatment options include:

• Lifestyle changes: Losing weight, avoiding alcohol before bedtime, and treating nasal congestion can help reduce snoring. Changing sleep positions, such as sleeping on the side instead of the back, may also help.
• Continuous Positive Airway Pressure (CPAP): This therapy involves wearing a mask over the nose and/or mouth during sleep. The mask is connected to a machine that delivers a continuous flow of air, helping to keep the airway open and reduce snoring. CPAP is often used for individuals with obstructive sleep apnea but can also be effective for treating severe snoring without apnea.<ref name="Randerath">Randerath, W. J., Verbraecken, J., Andreas, S., Bettega, G., Boudewyns, A., Hamans, E., ... & Sanner, B. (2011). Non-CPAP therapies in obstructive sleep apnoea. European Respiratory Journal, 37(5), 1000-1028.</ref>
• Oral appliances: Specially designed dental devices can help keep the airway open during sleep by repositioning the lower jaw and tongue. These appliances are custom-fitted by a dentist with expertise in sleep dentistry and can be effective for some individuals with snoring or mild to moderate sleep apnea.<ref name="Sutherland">Sutherland, K., Vanderveken, O. M., Tsuda, H., Marklund, M., Gagnadoux, F., Kushida, C. A., ... & Cistulli, P. A. (2014). Oral appliance treatment for obstructive sleep apnea: an update. Journal of Clinical Sleep Medicine, 10(2), 215-227.</ref>
• Surgery: Various surgical procedures can be performed to address the anatomical factors contributing to snoring. These may include uvulopalatopharyngoplasty (UPPP), which removes excess tissue from the throat; genioglossus advancement, which repositions the tongue to open the airway; or radiofrequency ablation, which shrinks tissue in the airway. The effectiveness of these procedures varies, and they are typically considered when other treatment options have not been successful or are not appropriate.<ref name="Walker">Walker, R. P., & Grigg-Damberger, M. M. (2005). Uvulopalatopharyngoplasty versus continuous positive airway pressure for the treatment of obstructive sleep apnea: a meta-analysis. Laryngoscope, 115(5), 850-854.</ref>

Prevention

Preventative measures for snoring can include maintaining a healthy weight, avoiding alcohol consumption close to bedtime, treating nasal congestion, and practicing good sleep hygiene, such as establishing a consistent sleep schedule and creating a comfortable, quiet sleep environment.

Complications

Snoring can lead to sleep deprivation, both for the individual who snores and for anyone sharing their sleeping environment. Additionally, snoring can be a sign of underlying sleep disorders, such as obstructive sleep apnea, which is associated with an increased risk of high blood pressure, heart disease, stroke, and other health problems.<ref name="Peppard">Peppard, P. E., Young, T., Barnet, J. H., Palta, M., Hagen, E. W., & Hla, K. M. (2013). Increased prevalence of sleep-disordered breathing in adults. American Journal of Epidemiology, 177(9), 1006-1014.</ref>

See also

• Obstructive sleep apnea
• Sleep deprivation
• Sleep disorders
• Polysomnography

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