Snoring

File:Pig snoring.ogv

Snoring

Vibration of respiratory structures causing noise during sleep

Snoring
File:Pig snoring.ogv
Synonyms	Sleep-related breathing noise
Pronounce
Field	Otorhinolaryngology, Sleep medicine
Symptoms	Vibratory noise during sleep, disrupted sleep, daytime fatigue
Complications	Obstructive sleep apnea, sleep deprivation, relationship strain
Onset	Any age, more common with aging
Duration	Chronic or occasional
Types	Primary snoring, snoring with obstructive sleep apnea
Causes	Airway obstruction, obesity, alcohol use, anatomical factors
Risks	Male sex, obesity, nasal congestion, smoking, sleeping position
Diagnosis	Sleep study (polysomnography), physical examination
Differential diagnosis	Obstructive sleep apnea, upper airway resistance syndrome
Prevention	Weight management, avoiding alcohol, nasal decongestion, sleep position changes
Treatment	Lifestyle changes, Continuous Positive Airway Pressure (CPAP), oral appliances, surgery
Medication	Decongestants (for nasal congestion)
Prognosis	Improves with treatment, but may persist
Frequency	~40% of adult men, ~25% of adult women snore regularly
Deaths	Rare, unless linked to severe obstructive sleep apnea

Snoring is the vibration of respiratory structures due to partial airway obstruction during sleep, leading to the production of sound. The intensity of snoring can range from soft and harmless to loud and disruptive. Chronic snoring may indicate an underlying condition such as obstructive sleep apnea (OSA), which can lead to significant health complications.

Snoring is a common cause of sleep disruption for both the affected individual and their sleeping partner. It is often linked to poor sleep quality, fatigue, and daytime drowsiness. In some cases, it may be a sign of an underlying sleep disorder that requires medical evaluation and treatment.

Causes

Snoring occurs when airflow through the nose and throat is partially blocked, leading to turbulence and vibration of soft tissues. Several factors contribute to this obstruction:

• Anatomical factors – Enlarged tonsils, a long uvula, a deviated nasal septum, a small jaw (micrognathia), or excess throat tissue can narrow the airway.
• Obesity – Excess fat around the neck (central obesity) can increase airway resistance and lead to upper airway collapse.
• Nasal congestion – Allergies, colds, or sinus infections can block nasal airflow, forcing more breathing through the mouth, which increases snoring.
• Alcohol consumption – Alcohol relaxes the muscles of the throat, leading to airway narrowing.
• Sleeping position – Sleeping on the back allows the tongue and soft tissues to collapse toward the airway, increasing the likelihood of snoring.
• Age – As people age, throat muscles lose tone, increasing the risk of airway collapse.
• Smoking – Irritation and inflammation of airway tissues can contribute to snoring.
• Genetics – A family history of snoring or obstructive sleep apnea can increase the likelihood of developing the condition.

Diagnosis

1. Clinical Evaluation A doctor will conduct a physical examination, focusing on:

• Throat and nasal structures (enlarged tonsils, deviated septum)
• Body Mass Index (BMI)
• Neck circumference (>17 inches in men, >16 inches in women is a risk factor for OSA)

A sleep history may also be taken, including:

• Frequency and severity of snoring
• Daytime sleepiness and fatigue
• Observations from a bed partner (choking, gasping, apneic pauses)

2. Sleep Study (Polysomnography) If obstructive sleep apnea is suspected, a sleep study (polysomnography) may be performed to measure:

• Apnea-Hypopnea Index (AHI) – Determines the number of breathing pauses per hour.
• Oxygen saturation – Detects periods of low oxygen levels during sleep.

Treatment

Treatment depends on the severity of snoring, its impact on sleep quality, and whether it is associated with obstructive sleep apnea.

1. Lifestyle Modifications

• Weight loss – Reducing excess weight can significantly decrease airway obstruction.
• Changing sleep position – Sleeping on the side instead of the back can reduce airway collapse.
• Avoiding alcohol and sedatives – These relax throat muscles and worsen snoring.
• Nasal decongestion – Using nasal sprays or antihistamines can improve nasal airflow.

2. Medical and Device-Based Treatments

• Continuous Positive Airway Pressure (CPAP) – A machine that provides pressurized air to keep the airway open, especially for those with sleep apnea.
• Oral appliances – Custom-fitted mandibular advancement devices help reposition the lower jaw to keep the airway open.
• Nasal dilators – Adhesive strips or internal dilators can improve nasal airflow.

3. Surgical Interventions If conservative treatments fail, surgery may be considered:

• Uvulopalatopharyngoplasty (UPPP) – Removes excess soft tissue in the throat to widen the airway.
• Genioglossus advancement (GA) – Repositions the tongue forward to prevent airway collapse.
• Maxillomandibular advancement (MMA) – A major surgery that moves the upper and lower jaw forward to increase airway space.
• Radiofrequency ablation – Uses controlled heat to shrink and stiffen soft palate tissues.

Prevention

To reduce the likelihood of snoring:

• Maintain a healthy weight
• Avoid alcohol and sedatives before bedtime
• Practice good sleep hygiene
• Treat nasal congestion and allergies
• Use a humidifier to keep airways moist

Complications

Chronic snoring can lead to:

• Sleep deprivation – For both the snorer and their partner.
• Increased risk of cardiovascular disease – Snoring linked to sleep apnea can increase hypertension, heart disease, and stroke.
• Cognitive and mood disturbances – Poor sleep quality can cause memory issues, irritability, and depression.
• Social impact – Snoring can cause relationship strain, embarrassment, and social isolation.

Epidemiology

• 40% of adult men and 25% of adult women snore regularly.
• Risk increases with age, particularly after 40.
• Obese individuals are at higher risk due to excess throat tissue.
• More common in men due to differences in airway structure and fat distribution.

Snoring vs. Obstructive Sleep Apnea (OSA)

While snoring alone is not necessarily harmful, it can be an indicator of obstructive sleep apnea (OSA). The main differences are:

Feature	Snoring	Obstructive Sleep Apnea (OSA)
Cause	Airway vibration	Airway collapse
Breathing pauses	No	Yes (≥10 seconds)
Oxygen drops	No	Yes
Daytime sleepiness	Sometimes	Frequent
Treatment	Lifestyle changes, oral devices	CPAP, surgery

See Also

• Obstructive sleep apnea
• Sleep deprivation
• Polysomnography
• Continuous Positive Airway Pressure (CPAP)
• Upper airway resistance syndrome
• Mandibular advancement device

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