Medical Disclaimer: This content is for informational purposes and does not constitute medical advice. Please consult a health care provider prior to starting a new treatment or making changes to your treatment plan.
Sometimes during sleep, the airway may become narrow or obstructed, forcing the lungs and diaphragm to work harder to pull air in and out. Snoring is the sound that occurs when air forcibly passes over tissues in the back of the mouth and throat, causing them to flap or vibrate. Sometimes there are nasal blockages, deviated septa, and sinus conditions that block the airflow. Some people have conditions that restrict airflow, increasing the chances of snoring in their sleep.
According to the American Academy of Sleep Medicine (AASM), habitual snoring occurs in 40% of adult men, 24% of adult women, and up to 12% of children. These numbers generally increase with age.
Snoring can occur at any point during the breathing cycle, while inhaling or exhaling. Although it is not harmful, there are some cases where snoring may indicate the presence of a potential illness. Learning about the factors that cause snoring can help you decide whether it may be helpful to talk to a doctor about your sleep health.
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is a breathing disorder that is characterized by abnormal relaxation of the upper airway, the space that extends from behind the nose and mouth to the top of the trachea and vocal cords. During sleep, the upper airway may repeatedly collapse either partially or completely for up to 30 seconds or longer.
In other words, a person with obstructive sleep apnea may have impaired breathing due to the partial or complete closure of the airway. Obstructed breathing can lead to a number of symptoms, with loud and habitual snoring being the most common. In fact, researchers have found that louder and more intense snoring correlates with more severe types of OSA.
Other symptoms of obstructive sleep apnea include:
- Daytime sleepiness
- Waking up multiple times at night
- Interruptions in breathing, gasping for air, or choking
- Morning headaches
While OSA may affect anyone, it is most commonly seen in older males. On a global scale, experts estimate that 1.35 billion people around the world between the ages of 30 and 69 experience mild to severe types of OSA. However, many cases go undiagnosed.
Although anyone may experience snoring, the chances increase with excess weight. As weight increases, more fat can accumulate in the neck region, which expands the size of the neck. This additional pressure may contribute to the airway becoming narrow or blocked.
Breathing through a narrow airway while sleeping can cause snoring. Over time, the narrowing airway may partially or completely collapse, leading to disrupted sleep and obstructive sleep apnea.
To help reduce the risk of snoring or experiencing sleep apnea associated with obesity, experts generally recommend weight loss. The benefits of weight loss may also include better sleep, improved blood pressure, and better overall physical health.
Like anything done a particular way over a period of time, sleeping position can become a habit. While each sleeping position may be beneficial in some ways, they also may contribute to snoring. Research suggests that sleeping position is a key factor in almost 70% of people who snore.
Lying on the back, also known as the supine position, increases the likelihood of snoring, mainly due to the impact of gravity on the upper airways. While lying on the back, the tongue has a natural tendency to relax and fall back into the throat and occupy the airway, leading to obstruction and snoring.
To help reduce snoring, experts recommend sleeping on the side, also known as the lateral position.
Allergies and infections can lead to a stuffy nose and may impact the ability to go to sleep or remain asleep. Nasal congestion can lead to swelling, inflammation, and blockages in the upper airway, which may cause a person to snore.
Allergies affect up to 30% of both children and adults in the United States. Allergies are a reaction from the immune system to substances a person may come into contact with in their environment. Common allergens include food, medications, mold, pollen, dust mites, and pet dander, among others.
People with allergies may experience mild or severe reactions ranging from a simple cough to anaphylaxis — a severe reaction that requires immediate medical attention. An allergic reaction can affect the upper airway in a number of ways, causing symptoms that include:
- Nasal obstruction
- Scratchy throat
- Runny nose and sneezing
Respiratory infections are illnesses that usually affect the airways and the lungs, which can cause discomfort, make it difficult to breathe, and may worsen sleep. Symptoms of respiratory infections are similar to the symptoms of allergies, and may cause snoring and other sleep disturbances.
When respiratory infections are caused by viruses, they typically resolve on their own after a short period of time without the need for medications. However, it is important to discuss any persistent symptoms with a health care provider.
Differences in the bones that make up the face and the skull can lead to narrow airways, which can cause snoring. These bones are called craniofacial bones and they fuse at birth. When they fail to fuse correctly, they are called craniofacial abnormalities, which are birth defects.
They can impact the way a person looks, and sometimes, how they breathe.
Micrognathia is a birth defect of the facial bones where the jaw is too small for the face, tongue, and other structures in the mouth. In a newborn baby, it can cause an obstruction of the airway, which may lead to difficulty breathing. While cases of micrognathia are usually mild, some may be severe and require surgery to fix the obstruction of the airway.
Midfacial hypoplasia occurs when structures in the middle of the face such as the upper lip, nose, and cheek bones fail to develop normally. As a result, those structures do not fuse correctly. This defect may lead to collapse of the airway during sleep, which can lead to snoring and difficulty sleeping.
Macroglossia is defined as a larger than normal tongue. It can be harmless, but in some cases, it can cause noisy or high pitched sounds, drooling, and obstruction of the airway. As with other craniofacial abnormalities, macroglossia can cause a decrease in the size of the upper airways and may increase the chances of airway collapse while sleeping.
Infants who are “tongue-tied” have restricted movement of the tongue. This can influence the growth and development of the craniofacial bones and musculature and restrict the clean flow of air into the lungs.
Medications are usually given to help treat an illness or to reduce certain symptoms. Some medications can affect the muscles and airways and may cause snoring.
Benzodiazepines are important medications used to treat seizures, insomnia, and anxiety. These sedatives can make falling asleep easier and help users sleep for a longer period of time. Benzodiazepines relax muscles throughout the body, including in the airway. In some cases, this can cause slow, shallow breathing and lead to snoring.
Narcotics are medications used for treating and managing pain. Like benzodiazepines, they can also cause slow and shallow breathing by decreasing activity of muscles used in breathing. Long-term use of opioids and benzodiazepines can increase the risk of central sleep apnea (CSA), a sleep disorder that is also characterized by daytime sleepiness, nighttime awakenings, and snoring.
Be sure to discuss with your physician whether there are any alternative, appropriate medications that do not affect the airway musculature.
Several changes can occur during pregnancy that may affect sleeping patterns and behaviors. This may be due to different hormones and physical changes that occur in the body. As pregnancy progresses, the airways become more narrow, which can make it easier for them to collapse.
Variations in hormone levels of estrogen and progesterone and increased blood flow during pregnancy may cause the nasal passage to become smaller. This can lead to a stuffy nose, which can make it more difficult to breathe in or out.
Pregnant people are more likely to snore than those who are not pregnant. Snoring, as a result, can lead to interrupted sleep, fatigue, and daytime sleepiness.
Drinking alcohol can temporarily make breathing difficult, which may lead to snoring. During sleep, alcohol can cause the muscles of the airway to lose their tone and strength and therefore increases their chance of collapsing.
Alcohol is a depressant, which means it can help muscles relax more and bring on sleepiness. However, heavy alcohol use can prevent deep sleep and lead to breathing interruptions. People who use alcohol frequently or are quitting alcohol after a long period of use are likely to experience difficulty falling and remaining asleep.
Experts recommend that those who wish to control their snoring or other disruptive sleep behaviors should not drink alcohol, especially within a few hours of bedtime.
Smoking is the process of inhaling tobacco and other substances. Any type of smoking can be harmful to the organs in the body. Cigarette smoke in particular contains over 7,000 chemicals, most of which are man-made. These chemicals can irritate the throat and other structures in the airway.
Exposure to these chemicals causes inflammation, which can be either acute or chronic. Smoking causes swelling of the upper airways and may contribute to snoring when inflammation is acute. Women in particular are at higher risk of developing snoring caused by smoking.
Like alcohol use, avoiding or quitting smoking may help to control snoring as well as reduce the risk of many other health problems.
When to Speak to Your Doctor
Snoring is not harmful, but it may affect others or be a sign of a serious medical condition. Snoring is one of the first signs or symptoms of obstructive sleep apnea and usually one of the main reasons a person is evaluated for obstructive sleep apnea or other upper airway problems.
You may want to speak to a doctor if you snore and experience any of the following situations:
- Complaint by a bed partner or disrupting their sleep
- Excessive daytime sleepiness
- Waking up multiple times at night
- Shortness of breath, choking, or gasping for air
Depending on the cause of snoring, there are several ways it could be treated. Practicing good sleep hygiene and sleep lifestyle is beneficial. Experts may recommend weight loss, avoiding tobacco smoking and alcohol, and sleeping in the lateral position. A custom made special dental mouthpiece called a Mandibular Advancement Device (MAD) can help reduce or eliminate snoring. In extreme cases, some types of surgery may be required to help reduce snoring. Regardless, if you are a chronic snorer, you owe it to yourself and loved ones to get checked for obstructive sleep apnea.