Everyone snores once in a while, but chronic snoring may have serious health and relationship consequences. Dr Adolf Lowies takes a look at what causes snoring – and what you can do to stop it.
Snoring must be one of the most democratic activities on earth, and it allows for absolute freedom of expression. The techniques manifested are varied and creative, from gentle, reassuring barely-there buzzing to high whistles and low growling, or the unrelenting droning of a chain saw. It can be a very touchy subject – those who snore often deny it, and those on the receiving end sometimes feel victimised or harassed by it. Your snoring may not bother you, but you can be fairly certain that your partner will have a different view! There’s even a medical term, spousal arousal syndrome (which sounds exciting, but unfortunately isn’t), to describe the suffering of snorers’ bedmates.
The problem with snorers is that they compete on all levels, from the soft ‘wannabe snorer’ you can scarcely hear, up to Olympic-class snoring that jars the teeth in the mouth and pursues you around the house, even through closed doors. And don’t let the size of a snorer fool you – the biggest man can sometimes sleep as quietly as an anaesthetised cat, while the sexiest, most petite person can emit a cacophony of sounds from her elfin facial features that would do justice to a bagpipe.
Snoring is actually no laughing matter and, quite apart from the marital discord it causes, may in fact reflect a bigger health problem. How do you restore silence and harmony to this unhappy scene before these physical problems become more serious, or the snoring leads to further sleep disturbance and marital discord?
WHY DO WE SNORE?
There’s a simple biological explanation: when you’re awake the muscles in your throat that keep it open are taut. They relax when you sleep, constricting the space for the air to pass through. The airflow is interrupted, the soft palate and the uvula, that tonsil-like, dangly thing in your throat, vibrate – and voilà, thunder and clamour in the darkness. Blocked noses, allergies and elongated uvulas can all cause snoring, but the chief culprit is the soft palate.
Like all our muscles, the soft palate becomes floppy over time. But you don’t have to be old and droopy to have a floppy palate. Cigarettes and alcohol can cause it to swell and lose its tone. Obesity is another factor – putting on weight narrows the airway.
WHAT CAN YOU DO ABOUT IT?
Many people snore. If you’re responsible for the racket, what can you do about it? Lots, in fact!
- Lose weight if you’re overweight. Don’t chug away on draught beer or eat six Big Macs less than three hours before supper. And get yourself to the gym. Improved muscle tone and less lard will help you to sleep, and you’ll be physically tired from working out. In some cases this is enough to sort out the problem.
- Avoid alcohol within four hours of going to sleep.
- Try tilting the head of your bed upwards by about 10cm.
- Use a soft, low pillow.
- Try sewing a ping-pong ball or tennis ball into the back of your pyjamas. This will prevent you from sleeping on your back, which is the position in which most people snore. Once you’ve got into the habit of sleeping on your side, you can remove the ball.
- Speak to your doctor about some of the mechanical devices and throat sprays now available. Beware of gimmicks sold on infomercials.
- Stop smoking. Smokers tend to be snorers.
- Get a check-up for allergies – there seems to be a correlation between snoring and allergies. It’s worth getting rid of potential allergens such as dust and down-filled pillows or duvets in your bedroom.
WHEN SNORING BECOMES LIFE-THREATENING
Snoring is caused by an obstruction or narrowing of the airway, which means that the body has to work harder to push air through. This puts pressure on the heart and over time can lead to high blood pressure or cardiac problems.
Ask yourself whether you suffer any of the following during your waking hours:
- chronic drowsiness
- decreased libido
- poor concentration
- nodding off to sleep at work
- personality changes.
If you have these symptoms, you’re probably suffering from obstructive sleep apnoea, the extreme of the snoring spectrum. This means that your airway blockages are so severe that you stop breathing altogether while you’re asleep. It usually happens when you’re sleeping on your back and your throat closes, blocking off your airway. You stop breathing – for as much as 10 seconds in some cases – after which you make a flatulent snorting sound and wake up. These blockages can cause CO2 levels to rise in your bloodstream and oxygen levels to fall dangerously low. The rising levels of CO2 in your bloodstream can then cause your pulmonary artery to go into spasm, putting strain on the heart and increasing the risk of sudden death from a heart attack while sleeping. Overweight middle-aged or older men are most commonly afflicted.
Sleep apnoea is not a pretty sight – or sound. There will probably be multiple interruptions to your sleep during the night, so no wonder you have the symptoms mentioned earlier. And, not surprisingly, the bouts of floundering and gasping can cause a lot of anxiety to your significant others.
Sleep apnoea can reflect a bigger problem, as it is often associated with arrhythmias and other cardiac complications. Even mild sleep apnoea has been linked with a fivefold increase in the risk of cardiovascular disease. The condition is also associated with an increased risk of high blood pressure, weight gain, memory problems, depression, impotence and even car accidents. It also causes many marital problems. Except for weight loss if you are obese, there are no complementary therapies. See your doctor.
TREATING SLEEP APNOEA
There are several forms of treatment for sleep apnoea.
Respiratory ventilation machines. A continuous positive airway pressure (CPAP) machine delivers a stream of compressed air via a hose to a nasal pillow, nose mask or full-face mask, splinting the airway (keeping it open under air pressure) so that unobstructed breathing becomes possible. The CPAP machine blows air at a prescribed pressure (also called the titrated pressure), which is usually determined by a sleep physician after review of a study done during an overnight stay in a sleep laboratory.
Dental appliances, oral devices, and lower jaw adjustment devices. Most dental devices are acrylic and fit inside the mouth, much like an athletic mouth guard or orthodontic appliance. Others fit around the head and chin to adjust the position of the lower jaw. Two common oral devices are the mandibular repositioning device and the tongue-retaining device. These open the airway by bringing the lower jaw or tongue forward during sleep.
While oral devices are less cumbersome than CPAP and relatively simple to use, they are only effective for mild to moderate sleep apnoea. Mild side effects are common but rarely require intervention. Nevertheless, close follow-up during long-term therapy by oral appliances is advisable in order to timely detect potentially relevant orthodontic changes. It’s very important to have the device fitted by a dentist who specialises in sleep apnoea, and to see the dentist on a regular basis to check for dental problems.
The Pillar procedure. A minimally invasive surgical technique called the Pillar procedure may be an effective long-term treatment for mild to moderate obstructive sleep apnoea. Small polyester implants are inserted into the soft palate to stiffen the tissue and avoid both the flutter that causes snoring and obstruction of the upper airway by the palate. Studies have shown significant improvements in snoring intensity, daytime sleepiness and the apnoea-hypopnoea index, a measure of breathing interruptions during sleep, and indicate that the improvements may be permanent.
ALTERNATIVE AND NATURAL APPROACHES
Aromatherapy can help prevent snoring. It’s best to consult with a qualified aromatherapist, who will make a blend of oils to use as a massage lotion for the neck and throat or as a gargle to soothe the inflamed airway. Some of the stronger essential oils can be used in a steam bath to encourage the expulsion of mucus, thereby clearing the airway.
Herbal remedies. There are herbal remedies that can clear the airway, allowing the unrestricted passage of air, and dispel mucus and congestion in the sinuses.
Homeopathic treatment works on the basis of treating the person and not the disease or condition. It is therefore difficult to predict which homeopathic remedies might be offered to alleviate snoring – it will depend on what the homeopath determines is the underlying personality type causing the condition.
Reflexology can be used very effectively to stimulate organs, especially those involved in the elimination process. It is therefore very good for clearing congestion if this is thought to be at the root of the snoring problem.
The natural remedies can be as effective as anything else in curing snoring, but it is essential that anyone who snores is checked by their doctor to ensure that the snoring is not a sign of a more serious underlying health condition.
Snoring is no laughing matter, and can reflect serious health problems. Fortunately there is help available, and you can do a lot about it if you accept responsibility for it.
- Reader’s Digest Guide to Medical Cures and Treatments. Cape Town: Reader’s Digest Association, 1996.
- Family Medical Companion. Scotland: Geddes & Grosset, 1996.
- Snoring by William Smook. 29 Jan 2009 Health.24
- Men’s Health magazine.