Snoring

Snoring is the sound that is made when breathing causes fluttering of tissues in the airway in the nose or at the back of the throat during sleep.

Almost everyone snores occasionally, but frequent snoring occurs in an estimated 28% to 44% of middle-aged adults.

By learning more about snoring’s causes, diagnosis, and treatment, you can address snoring and recognize when it may be tied to an underlying health problem.

Causes of Snoring

Snoring occurs when breathing during sleep causes the tissue around the airway to vibrate. As air moves through the back of the throat, loose tissue can flutter like a flag in the wind, and that vibration produces the sounds of snoring.

Snoring occurs during sleep in part because the muscles in the back of the mouth are relaxed, which makes them more susceptible to fluttering. This effect is amplified when the airway is narrowed or obstructed, causing airflow from breathing to move faster.

A number of factors can increase the likelihood of snoring.

  • Nasal congestion: Both allergies and colds can stuff up the nose. This congestion can increase airflow resistance, contributing to more vibration and snoring.
  • Anatomical features in the mouth or nose: Certain physical features can impact how air moves through the mouth or nose. In the mouth, this includes enlargement of the tongue, tonsils, or soft palate, which is part of the roof of the mouth near the throat. In the nose, this includes growths called nasal polyps or a deviated septum.
  • Pregnancy: Snoring often increases during pregnancy and may be a result of swelling, nasal congestion, or weight gain.
  • Obesity: Obesity is associated with the presence of additional or enlarged tissue that can obstruct the upper airway.
  • Using sedative medications: Substances such as alcohol, narcotics, muscle relaxants, and many sleep aids can cause muscles in the airway to slacken, leading to looser tissue that is more prone to vibrating.

When to Be Concerned About Snoring

Occasional snoring is common and typically not a cause for concern. However, frequent or excessive snoring may be a sign of an underlying health problem.

Certain signs and symptoms that may reflect a health issue related to snoring include: 

  • Loud and continuous snoring
  • Snoring that involves gasping, choking, or other breathing disruptions
  • Excessive daytime sleepiness
  • Frequent morning headaches
  • High blood pressure
  • Obesity

These symptoms may be tied to obstructive sleep apnea (OSA), a condition involving repeated pauses in breathing during sleep that are caused by a blockage of the airway. Frequent and loud snoring is common in people with OSA. In many cases, a person only becomes aware of this snoring when told about it by a bed partner. 

OSA causes lower quality sleep and problems staying awake during the day, which impacts safety and concentration. It is also associated with potentially serious health problems including cardiovascular diseases like heart attack and stroke. As a result, it is important for people with symptoms of OSA to talk with a doctor or sleep specialist. 

Even when not related to sleep apnea, frequent snoring may have negative consequences. Research suggests that regularly snoring may damage the arteries in the neck. Snoring can also disturb a bed partner or roommate and affect personal relationships.

Snoring can be related to several health issues that can narrow the airway, so people who often snore and have other symptoms or health changes should consult with a doctor. Examples of conditions that can cause snoring from narrowing of the airway include: 

  • Irregularities in the anatomy of the nose or mouth
  • Nasal congestion
  • Underactive thyroid
  • Excessive production of growth hormone
  • Abnormal tonsil growth 

When to Talk to Your Doctor

Snoring that happens frequently should be mentioned to a doctor. It is also important to talk to a doctor if snoring involves choking or gasping sounds, is accompanied by daytime sleepiness or other health changes, or is disrupting the sleep of a bed partner. 

A doctor can gather information about a person’s snoring and sleep habits, other symptoms, and overall health in order to determine the best course of action, including any necessary diagnostic testing or treatment. 

How is Snoring Diagnosed

Snoring is usually first detected by a bed partner, roommate, or family member, but health conditions related to snoring are diagnosed by a doctor. 

The diagnostic process starts with questions about snoring habits, sleep patterns, and other aspects of a person’s medical history. 

A bed partner or roommate may be involved in this discussion since they can often provide more detailed information about snoring. For people who sleep alone, other symptoms, such as daytime sleepiness or morning headaches, can be important to discuss. Additionally, smartphone apps to record snoring may be considered. 

A health care provider will also perform a physical exam. They may check the mouth, nose, and throat for signs of potential airway blockage. They often consider other factors, such as a person’s height, weight, and blood pressure, to look for signs of obstructive sleep apnea.  

Depending on the results of the medical review and physical exam, the doctor can determine whether additional testing with a sleep study is appropriate. 

Sleep Studies

Sleep studies are not usually necessary for people who snore but have no other symptoms or health problems. But if a doctor suspects that a person has sleep apnea, they will usually recommend a sleep study. 

The most detailed kind of sleep study uses a technique called polysomnography and is conducted during an overnight visit to a sleep lab. During the night, sensors closely monitor brain activity, heart rate, muscle movements, and breathing. 

Polysomnography can determine if a person has obstructive sleep apnea by quantifying the number and duration of breathing disruptions that happen during sleep. This can clarify whether snoring is related to sleep apnea

In some cases, an at-home sleep apnea test can be used instead of having to spend a night in a sleep clinic. At-home tests do not collect as much information and may not detect mild obstructive sleep apnea, so they are not appropriate for all people. Sometimes the results of an at-home test must be confirmed with in-clinic polysomnography. 

Even if a sleep study is not recommended, people who snore regularly should monitor their symptoms and discuss any changes to their snoring, sleep, or overall health with their doctor.  

Lifestyle Changes to Help Stop Snoring

Several lifestyle changes are typically recommended for people who snore. While none of these approaches works for everyone, they often can help reduce or stop snoring. 

Changing Sleep Positions

Changing sleep positions to avoid back sleeping may reduce snoring. Sleeping on the back can cause the tongue to fall back in the mouth and block the throat. In contrast, sleeping on the stomach, side, or with the upper body inclined at a 60-degree angle can help keep the airway open.

Switching how someone sleeps can be challenging, but there are ways to adjust to a different sleeping position. To achieve an angled position, sleepers can use blocks or another item to raise the legs at the head of the bed. A wedge-shaped pillow can also help prop up the upper body. 

A common strategy for learning to avoid back sleeping is to put a tennis ball in a sock and pin the sock to the back of a shirt. The tennis ball will press into the back if a sleeper rolls onto their back, and this can deter them from sleeping in that position without waking them up.

Avoiding Alcohol and Sedatives

By relaxing muscles around the airway, alcohol and sedative medications can make snoring more likely. For this reason, people who snore should avoid consuming alcohol or taking sedative drugs for at least a few hours before bedtime. 

Performing Mouth Exercises

Research suggests that mouth exercises can reduce snoring. These exercises are designed to strengthen muscles around the airway and improve breathing through the nose. A combination of exercises may be used to target parts of the face and mouth, including the soft palate, tongue, lips, and jaw. 

Physical Activity and Losing Weight

Weight loss is a commonly recommended approach to reduce snoring in people with obesity. Losing weight helps many people snore less often, but the degree of improvement varies among individuals. 

Exercise can be part of a strategy for weight loss, but it may help reduce snoring on its own. Research has found that exercising may decrease the frequency of disrupted breathing during sleep even in people who do not lose weight. 

Trying Nasal Strips

Drug-free nasal strips can be purchased over the counter at a pharmacy. Nasal strips widen the nostrils and allow for increased airflow. This may help people who snore, but nasal strips are not a suitable treatment for obstructive sleep apnea.

Medical Treatments for Snoring

Various types of medical treatments are available that may decrease snoring. The best type of treatment depends on the cause of the snoring. For example, snoring that is related to obstructive sleep apnea is often eliminated by treating the OSA. 

A health care provider can review an individual’s snoring habits and overall health and recommend the most appropriate treatment in their situation. 

Decongestants

Decongestants help clear a stuffy nose. If the nose is blocked because of a cold, a nasal decongestant before bedtime can reduce snoring. Decongestants are available as pills or can be applied directly into the nose, such as with a nasal spray. A doctor or pharmacist can help recommend a specific nasal decongestant.

Oral Appliances

Oral appliances are custom-fitted mouthpieces designed to reduce snoring by opening up the airway. Oral appliances may keep the tongue forward in the mouth, bring the jaw forward, or alter the position of the soft palate. 

Expert groups support the use of oral appliances as a treatment for snoring in people who do not have sleep apnea. Using oral appliances may enhance sleep for people who snore and their bed partners.

Potential side effects of oral appliances include increased drooling and misalignment of teeth. Mouthpieces can be uncomfortable to some, but many people are able to get accustomed to using them without serious complaints. 

CPAP Therapy

Continuous positive airway pressure (CPAP) therapy is commonly used as the initial medical treatment for obstructive sleep apnea, and it reduces or eliminates snoring. 

A CPAP machine pumps pressurized air through a hose connected to a mask that covers the mouth and/or nose. The constant stream of air holds the airway open and prevents breathing disruptions. 

Some CPAP users have a hard time sticking with CPAP therapy. Side effects can include nasal stuffiness or dryness as well as discomfort or claustrophobia from the CPAP mask.

CPAP therapy can reduce snoring in people who do not have sleep apnea, but insurance may not cover the cost of the CPAP device in these cases. 

Surgery

Surgery may be a treatment option to address breathing obstructions that impact snoring, such as enlarged tonsils, nasal polyps, or a deviated septum. However, the benefits of surgery for snoring are not clearly established, so surgery is usually only considered after someone has tried other treatments. 

Tips for Bed Partners of People Who Snore

Because snoring can be loud or bothersome, it can disrupt bed partners. Untreated snoring may contribute to conflict in personal relationships. In addition, bed partners may experience interrupted or insufficient sleep, leading to daytime sleepiness. 

Some tips that may help bed partners of people who snore include: 

  • Wearing ear plugs to block out noise
  • Using a white noise machine to mask the sound of snoring
  • Sleeping in a different room

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