Don't Ignore Snoring

November 5, 2006 by · Leave a Comment
Filed under: Health Tips Library, Sleep, Snoring 

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Don’t Ignore Snoring

David L. Steward, MD
University of Cincinnati College of Medicine

U p to 80% of men and 30% of women snore on occasion. Unfortunately, most people dismiss snoring as nothing more than a nuisance. That’s a mistake.

Snoring can be a sign of potentially serious health problems. Example: Obese people often snore. So do those with sleep apnea, in which breathing stops periodically during sleep. Both conditions increase the risk for high blood pressure and heart disease.

Anyone whose snoring is loud enough to disturb a bed partner — or is accompanied by morning headaches or daytime fatigue — should be evaluated by an otolaryngologist (ear, nose and throat specialist) who specializes in sleep disorders.

Main causes of snoring…

SLEEP APNEA

This condition is defined as a complete or partial breathing blockage occurring more than five times an hour or more than 40 times during eight hours of sleep. Many sleep apnea patients stop breathing hundreds of times per night. The sufferers must arouse themselves from sleep to start breathing again, which prevents them from getting restful sleep. Studies have shown that patients with sleep apnea may be so fatigued during the day that they have slower reaction times than drunk drivers.

Sleep apnea is usually caused by excess tissue in the throat that sags and obstructs the flow of air. The condition primarily affects overweight men and women. Men with a neck size of 17 inches or larger have the greatest risk of developing the condition. Both apnea and snoring can be significantly improved when patients lose weight.

A form-fitting mouthpiece, prescribed by a doctor, can help prevent snoring. It pulls the tongue and soft palate forward to keep the airways open. If the mouthpiece needs to be used nightly, a custom-made device is comfortable and will not cause jaw or dental problems. It can be ordered from your dentist or oral surgeon.

Also helpful: Sleep on your side. This position reduces the effect of gravity on tissues in the throat and helps keep the airways open.

Continuous positive airway pressure (CPAP), in which patients wear a pressurized mask during sleep, successfully eliminates apnea and snoring in nearly all patients, but requires nightly use to be effective. With CPAP, air is forced through the airways and prevents them from collapsing.

Until recently, surgery was the only other option. Depending on the patient, this may involve uvulopalatopharyngoplasty (removing tissue from the soft palate as well as the uvula), which is usually performed in conjunction with removal of tonsils… removing enlarged adenoids… or tightening throat tissue. In some cases, the upper and/or lower jaw may need reshaping to improve airflow.

New approach: Radio frequency therapy (somnoplasty) uses radio waves to shrink the soft palate or other enlarged tissues. The outpatient procedure, performed by an otolaryngologist with local anesthesia, takes about 30 minutes. Patients receive as many as five treatments. It’s safer than surgery, since it does not require general anesthesia — which can be risky for obese patients with sleep apnea — and can be used as an alternative to CPAP for serious apnea and snoring.

ALCOHOL

Drinking depresses the central nervous system, increases relaxation of throat muscles and promotes congestion by dilating blood vessels in the nose. Just one to two drinks can make snoring worse.

It’s fine for most people to have a beer or a glass of wine with dinner if snoring is mild — but don’t have a nightcap within two hours of bed. People with loud or frequent snoring may want to give up alcohol for a few weeks to see if it helps.

ALLERGIES

Nasal congestion that accompanies allergies results in mouth-breathing during sleep, which can increase snoring.

If you have itchy, watery eyes as well as congestion, allergies may be the culprit. To determine whether allergies are causing you to snore, use a decongestant nasal spray, such as oxymetazoline (Afrin), for a few nights. If the snoring improves, nasal congestion is probably the problem.

Caution: Do not continue using the spray. Daily use can cause rebound congestion that’s worse than the original problem.

Avoiding allergens is the best defense. Example: Stay indoors during peak pollen times (mornings and evenings)… wash your bedding in hot water weekly to kill dust mites… control mold by wiping damp surfaces with a mild bleach solution… and use a dehumidifier in basements or other damp areas.

Nonsedating oral antihistamines, such as loratadine (Claritin), can reduce nasal congestion and snoring. Your doctor may prescribe a nasal steroid spray, such as fluticasone (Flonase), to shrink nasal swelling. Intranasal steroid sprays don’t cause rebound congestion and are safe for long-term use.

DEVIATED SEPTUM

The partition between the nostrils is sometimes crooked, usually from birth or due to a broken nose or other trauma. This reduces airflow, which often causes snoring.

Air normally flows through alternate sides of the nose at different times — it switches every four to six hours. If you consistently breathe through only one side of your nose, you may have a deviated septum. Surgery to repair the septum is helpful in severe cases, but most patients simply can use a nasal steroid, such as triamcinolone (Nasacort) or budesonide (Rhinocort), to reduce swelling and help air to flow more smoothly.

Also helpful: Use an over-the-counter nasal strip, such as Breathe Right, to help hold the nasal passages open.

NASAL POLYPS

These benign growths are usually caused by persistent infections and/or allergies. A polyp no larger than a pencil eraser can obstruct normal airflow and cause snoring.

Polyps usually disappear once nasal inflammation or infection is treated with medication. If they don’t go away — or keep coming back — you may need to have them surgically removed in a 30- to 60-minute outpatient procedure that requires general anesthesia.

TURBINATE HYPERTROPHY

The turbinates are small, bony structures that protrude into the nasal airway. They’re covered with a mucous membrane that warms and moisturizes incoming air. Enlarged turbinates, due to allergies, obstruct airflow and often cause snoring.

Radio frequency treatments shrink turbinates and reduce snoring. Most patients need only one treatment to eliminate scar tissue and enlarge the nasal openings.

Bottom Line/Health interviewed David L. Steward, MD, associate professor and director of clinical trials research in the department of otolaryngology at the University of Cincinnati College of Medicine and member of the Obstructive Sleep Apnea Committee of the American Academy of Otolaryngology in Alexandria, Virginia.

Article Courtesy of Todays Health Tip

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