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Snoring














































Snoring

Snoring is a loud, hoarse, harsh breathing sound during sleep; excessive snoring may impact a spouse's sleep.

Severe snoring often results in Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS).

Snoring may impact an individual's mental condition during the day, necessitating medical attention.

The principle of snoring treatment aims to cure the primary disease and adjust the individual's living habits.


Definition

The primary reason for snoring is increased airway resistance due to obstruction or narrowing of the airway during sleep. As a result, it blocks the airflow through the airway and causes the soft tissues in the throat to vibrate, producing a loud sound. Thus, snoring is a loud, hoarse, harsh breathing sound during sleep. It is common in men and obese individuals. In serious cases, it can affect their mental state the next day, leading to daytime fatigue and drowsiness.



However, snoring can also signify a more serious health condition called Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS). In this case, an individual can have a repetitive complete or partial obstruction of breathing occurring hundreds of times throughout the night.



Epidemiology

Studies have proved that about 45% of men and 30% of women snore regularly. It can impact the snorer's sleep and that of a spouse, partner, or other family nearby. Moreover, it causes many couples to sleep in separate rooms and often strains marriages and relationships.



Causes

When snorers sleep, the muscles in their throat relax, and the tongue slips back into our mouth. Snoring occurs when something blocks air from flowing freely through the mouth and nose. When they breathe, the walls of their throat vibrate, causing the sound of snoring. Several factors can lead to snoring, including:



Cold, allergic rhinitis and tonsil hypertrophy can commonly cause snoring in children. Furthermore, cold can lead to nasal obstruction and open-mouth breathing, thus causing sleep snoring.

Ear, nose, and throat diseases can cause snoring. These diseases include tonsil hypertrophy, adenoid hypertrophy, nasal polyps, turbinate hypertrophy, rhinitis sinusitis, allergic rhinitis, deviated nasal septum, Flaccid soft palate, elongated and enlarged uvula. Similarly, tongue hypertrophy, glossocoma, and oral diseases result in the narrowing of the airway and cause snoring.

Severe snoring often results in Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS), a loud and irregular snoring accompanied by intermittent respiratory pauses. Snorers may have restless sleep and breath-holding. They may even wake up repeatedly from sleep with a suffocated feeling and may have the concomitant symptoms of dry mouth. Consequently, intermittent hypoxia at night can cause or aggravate cardiovascular and cerebrovascular diseases and metabolic disorders. These extreme outcomes can cause sudden death at night and traffic accidents.


Many lifestyle behaviors or mental states can cause snoring, including:



Obesity: If snorers are overweight, the extra tissues in their neck can pressure your airways.

Pregnancy: Tissue swelling during the last month of pregnancy.

Stuffy nose: It can occur due to cold or allergies causing snoring.

Smoking: For children, long-term exposure to cigarette smoke can also increase the risk of snoring. Similarly, long-term smoking in adults can aggravate snoring problems.

Poor muscle tone: Aging or sleeping pills user, antihistamines, alcohol, or sleeping on their back at bedtime can create poor muscle tone.


Symptoms

Apnea, wheezing, and irregular or broken snoring during sleep or waking up gasping.

Loud snoring, tossing and turning in sleep, and restless sleep are common symptoms of snoring.

When severe, snoring can cause frequent awakenings at night and daytime sleepiness.

Snorers are often drowsy and have difficulty concentrating during the day.

Snoring can disrupt one's bed partner's sleep.

Diagnosis

Occasional snoring is normal. If someone already realizes snoring, doctors should examine it. They can discuss any other issues related to sleeping. For instance, if anyone has ever told them, they could stop breathing, gasp, or make choking sounds while sleeping. After visiting a physician, they can get a proper examination and get advice. Here are some tests to evaluate the severity of snoring:



Ear, nose, and throat examination

The physician will then complete a sleep evaluation (or refer the individual to conduct it) for polysomnography.

Pulmonary function examination

Electrocardiogram examination

Thyroid function examination


A dentist should not offer to treat your snoring without a proper diagnosis by a physician.



Treatment

1. The principle of snoring treatment is to cure the primary disease aggravating it. Moreover, people with undiagnosed primary disease should try to adjust their living habits to relieve snoring. Snorers can also relieve snoring by improving their lifestyle and sleeping habits. Here are some advice to avoid snoring:



Do not sleep flat on the back. Try to sleep on the side instead. Snorers can sew a golf or tennis ball into the back of their night clothes. If they roll over, the ball's pressure will help remind they to stay on their side. Over time, side sleeping will become a habit.

Use pillows with moderate height, which can help maintain the head and neck in a position with a straightened and unobstructed airway. This process can help relieve snoring.

Lose weight if you are overweight. Losing weight to improve airway narrowing caused by fat accumulation in the throat may relieve snoring.

Quitting smoking can reduce airway inflammation or swelling and alleviate airway narrowing.

Avoid taking alcohol and sleeping pills before bedtime to prevent aggravating snoring.


2. Clinic Treatment. In some cases, snorers may require clinical treatment to evade their snoring habits. Here are some recommendations in this regard:



Use nasal sprays to relieve nasal congestion to help keep the airway unobstructed during sleep.

Oral appliances treat simple snoring and mild to moderate OSAHS.

Thyroxine treats underlying conditions such as hypothyroidism.

Surgery is the preferred method for treating OSAHS in children, including removing tonsils, adenoids, or mandibular malformations to improve upper airway ventilation.

The nasal surgery corrects the abnormal structure of the nasal cavity and improves the nasal ventilation function, such as septoplasty and nasal polypectomy.

Physicians also advise surgically removing the soft palate or uvula of excess tissue to enlarge the pharyngeal cavity, reducing snoring.


Intervention

Behavior Management

Obese or overweight snorers must maintain a balanced diet and create an exercise plan to reduce weight and relieve snoring. However, they should avoid extreme fatigue.

The general principle of the daily diet is to reduce energy intake in food and drinks. Snorers should minimize total food intake, escape snacks between meals, avoid overeating before bedtime, and eat more cereals and fiber-rich foods. Furthermore, it is healthy to consume fruits and vegetables, choose low-fat foods, and avoid excessive fat intake.

Most snorers are obese, so moderate physical exercise is vital to reduce their weight. They should perform 30-60 minutes of moderate-intensity physical activity daily with a heart rate of 100 to 120 beats/min.

Monitoring Diary

During the treatment of snoring, the physicians recommend the efficacy assessment test once a month. They check whether the symptoms of snoring have been improved or disappeared and whether daily life has returned to normal.


Prevention

Experts recommend that obese and snoring individuals maintain a balanced diet, which can help reduce weight and relieve snoring.

Snorers should get enough sleep because regular sleep can help improve sleep quality and reduce snoring.


Prognosis

If an individual of snoring cannot get rid of long-term snoring or has affected the mental state during the day. Regular snoring can lead to daytime sleepiness and fatigue, difficulty concentrating, drowsiness, and other problems. They should immediately seek medical attention.



Complications

The weight loss may reduce comorbidities in snorers with simple snoring. The frequency of comorbidities such as cardiovascular, endocrine, and neuropsychiatric diseases increases with advanced age. On the other hand, neuropsychiatric diseases may be associated with daytime drowsiness. Some recent studies suggest that severe, chronic snoring may even cause thickening of the carotid arteries, potentially increasing the risk of stroke.

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