Snoring is the noisy breathing that occurs when the upper airway (nose, mouth, throat) gets narrowed or becomes occluded, during sleep.
The soft tissues in the nose, soft palate, uvula, tongue, lateral walls of the throat, epiglottis, encroach on the airways, and vibrate as respiring air blows over them, to generate the noise.
Almost, everybody snores occasionally, when they fall asleep, however, some are habitual snorers.
Sleep period is a continuous repetition of the sleep cycle every 90 minutes and it’s divided into 4 stages. The first 3 stages are grouped under non-REM, the 4th stage occurs when there is a rapid eyeball movement (REM) during sleep and is known as REM sleep stage.
Stage 1: starts with light sleep, associated with hypnic jerks/jolts, as individuals try to stay awake.
Stage 2: There is a loss of awareness but individuals can easily be aroused from the sleep.
Stage 3: Deeper sleep state where it is difficult to arouse someone in this stage. When aroused from sleep, they would still feel sleepy with impaired mentation for about 30 minutes
Stage 4: REM Sleep. The last 20 minutes of a sleep cycle is known as REM sleep. Two events occur during this stage, these are; Vivid dreams occur and Muscles lose their tone (except the muscles of the eyeball and the diaphragm).
Light snorers do snore uniformly throughout all the sleep stages. Heavy snorers, snore more during REM sleep when there is a generalized loss of muscle tone.
CAUSES OF SNORING
Snoring occurs anytime the airways are partially or completely occluded.
. Nasal congestion (from nasal allergies and viral colds), Swollen nasal turbinates, Nasal polyps
. Abnormalities of the Nasal septum (deviations, dislocations and hematoma)
structures that may narrow the airways include
. Enlarged Tonsils (especially in children).
. Large and/or soft tongues preclude air passage from nose/mouth into the lower airways
. Long and soft uvula. Uvula of habitual snorers contain fewer muscles than non-snorers
. Long soft palate.
. Loss of tone in Throat muscles due to Alcohol Sleep deprivation, Sedative medications
RISK FACTOR FOR SNORING
- . Male sex
- . Being overweight/ Obese leading to bulky neck/throat tissue that could narrow the airway
- . Use of Central Nervous System depressants: Alcohol consumption, sleeping pills
- . A family history of snoring
- . Daytime mouth breathing
- . Frequent sore throats
- . Low maternal Education is a risk factor for boys.
- . Tobacco exposure
- . Sleeping supine/back position, allows the tongue to fall back, under gravity, to block the airways
COMPLICATIONS OF SNORING
- . Snoring disturbs the sleep of bed-partners and room-mates. Loud snoring may even, strain relationships.
- . The vibrations of snoring may damage the lining of blood vessels and promote atherosclerosis formation (1)
- . Heavy snoring may interfere with sleep and results in inadequate sleep. Snorers may fall asleep while driving
- Snorers may also complain of tiredness and headaches.
- . Snorers may develop Depressive disorders, Inattention and inability to complete tasks and school home works
- . Snoring becomes a major health problem when it as associated with sleep apnea. 50% of snorers have sleep apnea
PRIMARY & SECONDARY PREVENTION OF SNORING
This includes adopting measures to control the preventable risk factors for snoring
- Weight loss if overweight
- Avoid evening/bedtime alcohol consumption.
- Avoid smoking, avoid sleeping pills and muscle relaxants.
- Postural therapy: Avoid sleeping on your back. You may sleep on your side or on your belly.
INTERVENTIONS AVAILABLE FOR SNORING
Snoring treatments are not permanently curative, usually temporary
Nasal Obstruction: Nasal steroid sprays, daily antihistamines, and oral anti-inflammatory medications, help.
Tongue: If the tongue is found to contribute to snoring, Oral devices may be used to bring the lower jaw forward and prevent the tongue from moving backwards during sleep.
Soft Palate: Snoring traceable to soft palate problems may be managed by ENT surgeons. Radiofrequency ablation of the soft palate, Palatal suspension surgery, and surgical implants and injection of chemicals to stiffen the soft palate may be done
An intervention is deemed successful if Bed partners are no more disturbed by snoring
Source: Dr Alex K Sarkodie