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What causes snoring?
The back of our throat where the sound of snoring comes from is called the pharynx. The pharynx is located just behind our tongue.
Normally, when we are awake, the pharynx is held open by several small muscles. However when we sleep, these small muscles relax and therefore the walls of the pharynx becomes much looser.
When air flows through a relaxed pharynx, the walls vibrate and snoring occurs. The narrower it is, the more easily it will vibrate and the louder you will snore.
How common is snoring?
About 40% of men have at least mild snoring, on at least some nights. This number is about 30% for women.
People of any age can snore. Even some children have a problem with snoring. But the age group most at risk are middle aged people.
Factors that can make you snore more
Being overweight or obese will mean you have more fat around the neck. This will make your throat narrower and it will vibrate more easily.
Sleeping on your back makes your tongue fall directly back. This can get in the way of your airflow so Snoring is almost always worse when you are sleeping on your back.
Alcohol consumption close to bed time
Drinking alcohol will relax the muscles in your throat. This will mean more vibration and more sound.
People who breathe through the mouth are more likely to snore
This is because the walls of your throat at the back of the mouth vibrate more easily than the back of your nasal cavity.
Some of the reasons why one would breathe through the mouth includes
- Nasal obstruction due to adenoids or nasal polyps
- Nasal blockage due to chronic allergic rhinitis
Snoring can also be caused by other medical conditions resulting in airway obstruction like
- Enlarged tongue
- Enlarged tonsils
- Enlarged thyroid
- A small and retracted jaw
Certain medications intake like
- Sleeping tablets
- Epilepsy drugs and oral steroids
- Anaesthetic drugs
Can increase your snoring.
How snoring affects you and your family?
For many families snoring is a big problem. Often, the snorer has to sleep alone in another room. If not, then his or her family will have trouble getting a good night's sleep.
The family might be more tired during the day. This can mean that they can't focus as well on work or study. Some snorers also have a condition known as obstructive sleep apnoea. Over 10-20% of regular snorers have this condition. Sleep apnoea is linked to high blood pressure, heart attacks and strokes.
Treatment of Snoring
The key to reduce snoring is to identify the cause of your snoring.
If you are obese, then weight loss would be the most crucial in reducing your snoring. Reduce calorie intake by reducing 20-30% of every meal. Increase your exercise duration per week gradually to eventually hit 150 minutes a week.
Treating allergic rhinitis
Treatment of allergic rhinitis includes avoiding dust, regular medicated nasal puff and even oral antihistamine to reduce the swelling of your nasal turbinates. This will help reduce snoring.
Adjust sleeping position
Lying on your back makes the base of your tongue and soft palate collapse easily. Sleeping on your side may prevent this.
Using a body pillow, which is a full length pillow that supports your entire body provides an easy fix. Or you could try to elevate your head by using thicker pillows or more pillows.
Limit or avoid alcohol before bed
Alcohol and sedatives reduce the resting tone of the muscles in the back of your throat, making you more likely to snore. Drinking alcohol 4-5 hours before sleeping makes snoring worse, so please avoid that.
Get adequate sleep
Insufficient sleep or poor sleeping habits have an effect that is very similar to drinking alcohol.
When you are over-tired, you sleep hard and deep and the muscles at the back of your throat becomes floppier, which creates snoring.
Oral appliances or splints
One treatment is called a Mandibular Advancement Splint. It looks a bit like a mouthguard. You wear it between your teeth while you sleep. It pushes your lower jaw forward. This gives you a wider airway.
It needs to be specially fitted to you. You will need to see a dentist or oral surgeon for this.
Some treatments stiffen the roof of your mouth. This makes it vibrate less. This can be done using lasers, injections or implants or even surgery.
If you have seen an ENT doctor and have been diagnosed with enlarged adenoids or tonsils, then surgical removal may be part of an effective solution to reduce snoring.
Excluding obstructive sleep apnoea
Problem snoring may be an early warning signal that sleep apnoea is present. Get it diagnosed and treated.
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)