Snoring is one of those things in life that doesn’t need an introduction. Every single one of us are very well familiar with this unmistakable harsh sound. Most people do experience snoring personally or by someone close to them such as family members, friends and a significant partner. Interestingly, many people who snore do not even realize that they do and the effect it has on their sleeping pattern or rest. Snoring has no preferences as it affects both old and young. It is usually not a problem for those who don’t snore but it can be if you sleep in the same room with a snorer or worst share the same bed! The non snorer will usually experience a sleepless night tossing and turning the entire night at the mercy of the snorer. The snorer may as well wake frequently, either from the snoring ( which they are not conscious of) or from the jab in the side from the sleeping partner or family member, when they have opportunity to do something about it. If you have a sleeping partner you might find that you have to sleep out of the room or your partner sleeps in another room. So, he or she snores and you sleep alone.

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It is not necessary for you to read further than the heading “What causes snoring?” since this answers the reason for snoring. However, the rest of information is provided as an additional reading for those who want or need more information on this topic. Now, read and be more informed - be wiser.

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What is Snoring?
Snoring is a loud, hoarse, or harsh breathing (vibratory) sound that happens while one is a asleep. This sound comes from turbulent air flow during the act of respiring through the open mouth so that the currents of inspired and expired air cause the tissues of the nose and throat (structures of the upper airway) to vibrate and give rise to snoring. This happens involuntarily.

What Causes Snoring?

When you are awake, you breathe in through your nose (and mouth) and the air passes in a steady stream that easily goes through your throat and down into your lungs. During this time there are relatively few sounds and breathing is usually quiet. This is due to a set of muscles in the back of our throat that are responsible for holding it open so that enough air can pass through. However, when we are asleep, these same muscles relaxes causing the airway in the back of your throat to become narrower (shrink). When air (the same amount when awake) passes through the narrower opening, it hits and cause the relaxed soft floppy palate (pronounce: pa-lut) tissues surrounding the opening to vibrate like a flag in the wind, which in effect cause the sounds of snoring. That is the vibration of the soft palate (the back of the roof of the mouth) and the uvula (pronounce: yoo-vyuh-luh) - the prominent structure dangling down at the back of the mouth. Most snoring occurs through the mouth through the confined passage where it is exacerbated. This causes the tongue to shift backwards thus further constricting breathing.
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When Snoring becomes a Medical Health Problem
- Obstructive Sleep Apnea (OSA)
Snoring is normally not harmful and is quite normal as a matter of fact, most healthy people do snore. If however, snoring gets to the point where it becomes extremely loud and disruptive to others, then this is now considered abnormal. Snoring in itself is not an illness but rather a symptom. Heavy snoring can be indicative of a more serious medical problem that disturbs sleeping patterns and deprives the snorer of necessary and adequate rest, such as in obstructive sleep apnea. This is a condition where the air passage becomes covered, usually by the tongue, due to abnormal (poor) muscle relaxation of the tongue and surrounding muscles in the throat area. When sleeping, this blocks the air passage making it difficult to breathe. It usually stops breathing for more than ten seconds during sleep. This obstruction usually causes the snorer to wake up or partially wake up for a short period of time gasping for breath, in an attempt to resume breathing. That means, the air passage is completely blocked while the lungs attempt to carry on the breathing process of respiration. The snorer usually don’t recall waking up to catch his or her breath but the frequency of waking up several times during sleep over many nights can have a cumulative effect that results in serious health problem. It is identified by the loud snores following the silence. This repetitive obstructed pauses that happen while gasping for air, causes oxygen level in the body to drop while in turn increasing the heart rate since the body is now trying to get more oxygen. This higher heart rate will therefore lead to a high blood pressure in the individual snorer. Due to the adequate low supply of oxygen level, it can cause severe health problem that can lead to a stroke or heart attack. It can also cause other heart diseases, diabetes, impotence, depression, personality changes, impaired concentration, heartburn, dry mouth, gastroesophageal reflux disease (GERD), irritability etc.

In addition, because the snorer wakes up several times during night, he or she will not be getting enough sleep. This will therefore take a severe toll on their daily activities during the day that can result in abnormal daytime sleepiness, lack of energy, decreased attention and poor concentration, falling asleep while driving or performing daily work etc. thus inadvertently being a threat to yourself and others.

Social Problem of Snoring
This may not be a medical problem, but it can become a serious social problem for the snorer, family members and sleeping partner. It often disrupts their sleep much more than it affects the snorer. Relationships often suffer as a result of this. Both will be unhappy, with the partner worrying about the well being of the snorer. The significant other may resort to sleeping in a separate room or the snorer, which results in a change in the sleeping habit of both partners sleeping together totally. The snorer will therefore feel isolated. Hence, snoring can affect the snorer both physically and socially. Snore and you may find yourself sleeping alone.

Factors That Causes (Provokes) Snoring
The reason for snoring in some people is not known however there are certain factors that contribute to snoring. The following are potential causes of snoring:

i. Sleeping On Your Back
In this sleeping position gravity pulls the jaw and tongue down and back. This as a result, causes the mouth to open and the tongue to drop back into the airway which in turn causes the narrowing of the air passage.

ii. Smoking
Smoking may cause the swelling and inflammation of the lining of the throat which in effect causes the throat to become more narrow. That is, it increases nasal congestion and mucous in the throat area.

iii. Eating a large meal before bed
a full stomach when sleeping presses upwards on the diaphragm and can lead to labored breathing.

iiii. Family related
Have a history of relatives who snore. Snoring tends to run in families.

iv. Head shape
I know you are at awe with this one but having a round-shaped head rather than a long, thin head can be a factor. In round-headed people, the tissue has to fall back a shorter distance to narrow the throat (see - Sleep and Breathing 2001;5:79-91).

v. Breathe through mouth rather than through nose
Breathing through your mouth causes the inhale air to directly hit the back of the throat. This increasing turbulence which whips around in all different directions as it hits the relaxed, floppy tissues lining the throat causing vibration (snoring). On the other hand, in nose breathing, it enters the throat in parallel with it.

vi. Blockage of the nose - Difficulty with nasal breathing
Any blockage of the nose by cold, broken nose, inhaled irritants (allergies), pregnancy complications, blockage from polyps or the shifting of the nasal septum etc. can lead to snoring. All these factors cause the narrowing of the nasal passage which in turn, increases the air turbulence due to the increased resistance in the narrow nasal passage as it hits the floppy tissues lining the throat, causing vibration (snoring).

viii. A small lower jaw and size of throat and soft palate tissues
Having a small jaw and narrow throat and/or a large uvula or large tonsils and base of tongue can cause snoring. This is due to the fact that the reduction in space decreases the size of the airway and as such, causes an increase in one snoring. It is also worth noting that enlarged tonsils and adenoids are the primary cause of snoring in children.

viiii. Alcohol
This enhances the throat muscles during sleep, causing the muscles of the palate, tongue, neck, and pharynx to relax much more than normal leading to a smaller airway thus, increasing the air turbulence in the throat which in effect causes greater tissue vibration (snoring).

x. Medication
Taking drugs (medication) such as sleeping pills, tranquilizers and antihistamines can make the soft palate tissues and throat muscles (i.e. the muscles of the palate, tongue, neck, and pharynx) very relaxed, leading to the narrowing of the airway during sleep and thus, casing snoring by worsening the air turbulence in the throat.

xi. Obesity (overweight)
If you are overweight more muscle power is needed to hold the throat open if the neck is fat, and thus the throat will become more narrow as the muscles relax during sleep. In other words, obesity adds extra fat to the tongue and throat surrounding thus, making it easier for the airway to become blocked. If you are fat it is possible that weight loss can stop sleep apnoea.

It is important to note also that as one gets older, the soft palate tissues and muscles become increasingly flaccid with age thus increasing the frequency of snoring.

Signs and Symptoms of Snoring
Here are few symptoms of snoring. If you are experiencing some of these then it is possible that you have a snoring problem. This does not mean that because you are experiencing any one of these symptoms you therefore have a snoring problem. There could be other possible reasons for such symptoms. Nevertheless, these are some symptoms of snoring that should be taken seriously:

i. Recent weight gain

ii. Morning headaches

iii. Awaken at night confused

iiii. Excessive daytime drowsiness

iv. Awakening in the morning not feeling rested

v. Falling asleep while driving or performing daily work

vi. Change in your level of attention, concentration, or memory

vii. Several daytime naps or fall asleep during meetings [ if not from just being bored :) ]

viii. Observed by someone else where the snorer stop breathing or gasp during sleep can suggest a breathing problem like sleep apnea.

It is also important to note that sleep apnea in children has been linked to several health and learning problems such as; high blood pressure, growth problems, ADHD, bedwetting poor school performance and learning difficulties.

Treatments (remedies) For Snoring

If you do your research you will find there is no shortage of the number of remedies available to combat snoring. This is surely a blessing for the snorers and the non- snorers such as the spouse or family member who have to put up with it. Here are some self-help remedies:

Non-surgical treatments for snoring
Behavioral changes
Lifestyle:
Exercise often and lose weight if you are overweight.
Drugs:
Avoid sleeping pills, tranquilizers and antihistamines before bedtime and alcohol at least 4 hours before bed. If possible avoid drinking alcohol.
Eating Habit:
Avoid eating heavy meals and snacks three hours before going to bed.
Sleep:
Establish regular sleeping patterns.
Sleep Position:
Sleep on your side rather than on your back. You can also choose to elevate your head by using a bed pillows.
Medical Help:
If your snoring is very disruptive to other members of the family you should see a doctor . Also, if you or any member of the family is a heavy snorer who snore in any position then it is wise to visit your doctor.

Children that are chronic snorers should be examined by a doctor for problems of the tonsil or adenoids. As mentioned in the Symptoms for Snoring above, sleep apnea in children has been linked to several health and learning problems.

Other remedies
i. Steam inhalation: Steam inhalation helps to open the air passage. Taking a face steam-bath usually helps.
ii. Drinking Tea: Tea drinking can help weaken the snore.
iii. Use of nasal dilator strips (e.g. Breathe-rite strips)
iiii. Dental appliances -To prevent tongue from falling back.
iv. Palatoplasty: stiffening of the palate using injection
v. CPAP mask: a special device you wear over the nose at night while sleeping. This prevents the airway from becoming blocked thus, decreasing snoring and sleep apnea.
vi. Over-the-counter: anti-snoring devices and medications.

Surgical treatments for snoring
Surgical treatment of snoring is generally focused on the nasal passages, palate and uvula, and tongue.

a) Nasal surgery for snoring
This focuses on improving a narrow nasal passage. Nasal polyps are mucosal “growths” in the nose that are usually caused by allergies. If the polyps are large enough, it will require surgery to get rid of it. Correction of a deviated nasal septum. The nasal septum is the “wall” in the center of the nose that separates the right and left nasal passages. Usually caused by trauma such as during birth.

b) Oral surgery for snoring
This procedures that involve the uvula and palate. Some procedures remove the tissue whereas others try to stiffen the tissues.

Uvulectomy: - is the removal of the uvula
Laser Assisted uvulopalatoplasty (LAUP): - trimming the palate with a laser
Radio-frequency: - ablation of the palate
Palatoplasty: - stiffening of the palate using palate implants. This increases the "critical" air speed required to initiate the vibration that is required to cause snoring. This drastically reduces snoring.

Interestingly there are over 300 anti-snoring devices registered at the USA patent office alone!

Books worth reading on this topic:
Books on Snoring

Related Articles of Interest:
Why Do We Dream? | Why Do We Yawn? | What causes hiccup?