Snoring Complications: Symptoms, Causes And Treatment

Jan 20, 2023, 13:13 IST

By Dr. Anunya Reddy

Snoring is the harsh sound that occurs when air flows past relaxed tissues in your nose & throat, causing the sounds. Once in a while, everyone snores, but it's a problem when it becomes habitual not only to your partner but also affects your health.

Symptoms

Snoring can be associated with a sleep disorder called obstructive sleep apnea (OSA). OSA often is characterized by loud snoring followed by periods of silence when breathing stops or nearly stops. Eventually, this pause in breathing may signal you to wake up, and you may awaken with a loud snort or gasping sound.

If snoring is accompanied by any of the following symptoms, it may be an indication of OSA and you need further evaluation:

·Noticed breathing pauses during sleep

·Excessive daytime sleepiness

·Difficulty concentrating

·Morning headaches, moodiness

·Dry throat upon awakening

·Restless sleep

·Gasping or choking at night

·High blood pressure

·Chest pain at night

·Your snoring is so loud it's disrupting your partner's sleep

·In children poor attention span, behavioural issues, or poor performance in school

Causes

Snoring can be caused by the following factors:

·Age: snoring is most commonly seen in older adults as muscle tones reduce with age. It’s also seen in some children who have airway blocks such as enlarged tonsil or adenoids.

·Gender: Its seen most commonly in men than women

·Mouth anatomy: Some people may have a long soft palate, or large tonsils or adenoids, which can narrow the airway and cause snoring. In case a small jaw snoring is seen.

·Being overweight: People who are overweight or obese are more likely to snore due to extra tissues in the back of their throats that may narrow their airways.

·Alcohol consumption and drug use: Alcohol and some medications relaxes the muscles restricting airflow in mouth, nose and throat causing snoring.

·Nasal problems: Chronic nasal congestion, allergies, nasal polyps or deviated nasal septum may contribute to snoring.

·Poor muscle tone in your throat and tongue: When you doze off and progress from a light sleep to a deep sleep, the muscles in the roof of your mouth (soft palate), tongue and throat relax causing partial block of your airway.

·Sleep position: Snoring is typically more and loudest when sleeping on the back as gravity's effect on the throat narrows the airway.

·Having a family history of snoring or obstructive sleep apnea

·Pregnancy: Due to hormonal changes and weight gain

Complications

Besides from disrupting a bed partner's sleep, if snoring is associated with OSA, you may be at risk for complications such as

·Excessive Daytime sleepiness & disturbed night sleep

·Frequent frustration or anger

·A long-term OSA often raises blood pressure with a higher risk of heart attack & stroke.

·An increased risk of behaviour problems such as aggression or learning problems in children with OSA, difficulty concentrating

·An increased risk of vehicle accidents due to lack of sleep

When Should You See a Doctor About Snoring?

It’s essential to get an evaluation by your doctor if there are any of the following signs:

·Snoring that occurs three or more times per week

·Snoring with gasping, choking, or snorting sounds

·Obesity or recent weight gain

·Daytime drowsiness

·Lack of focus or mental sharpness

·Morning headaches and congestion

·High blood pressure

·Night time teeth grinding (bruxism)

·Frequent nighttime urination (nocturia)

Diagnosis

Diagnosis is made based on your signs, symptoms, your medical history & through physical examination along with imaging such as an X-ray, a CT scan or MRI to check your airway for problems and Sleep study is done either at home or lab depending on the severity of your snoring and other symptoms. This test is called polysomnography which records brain activity, blood oxygen level, heart rate, breathing rate, sleep stages, eye and leg movements & level of obstructions

Treatment

First recommend step to treat snoring is lifestyle changes, such as:

·Losing excess weight

·Avoiding alcohol close to bedtime

·Treating nasal congestion

·Maintaining good Sleep schedule

·Avoiding sleeping on your back

In severe cases where lifestyle is not helpful or in some anatomical problem we doctors may suggest:

Oral appliances such as MANDIBULAR ADVANCEMENT DEVICES or TONGUE RETAINING DEVICES that help advance the position of your jaw, tongue and soft palate to keep your air passage open, but excessive salivation, dry mouth, jaw pain and facial discomfort are possible side effects from wearing these devices.

Continuous positive airway pressure (CPAP)

This is one of the most common treatments for sleep apnea in adults. They pump air through a hose and a mask and into the airway, preventing it from being obstructed. Bi-PAP machines are similar but have different pressure levels for inhaling and exhaling. APAP machines are “smart” machines that vary the pressure as needed. CPAP, BiPAP and APAP machines are often effective in resolving sleep apnea and associated snoring.

In adults, surgery is rarely the first-line treatment unless other approaches are not effective.

a procedure called uvulopalatopharyngoplasty (UPPP) where we widen the airway by removing tissue to improve the airway space.

Septorhinoplasty or nasal polypectomy in case of deviated nasal septum or nasal polyps.

Another procedure called maxillomandibular advancement (MMA) involves moving the upper and lower jaws forward, which helps open the airway.

Radiofrequency tissue ablation gives a low-intensity radiofrequency signal to shrink tissue in the soft palate, tongue or nose.

A newer surgical technique called hypoglossal nerve stimulation can be done to control the forward movement of the tongue so the tongue does not fall back and block the airway while sleeping.

We evaluate children for tonsils and adenoids, and if required adenotonsillectomy is done.

Bottom line

If you snore regularly and it affects your energy level during the day, or if you have signs of chronic snoring, don't ignore it. Discuss the condition with your doctor and get appropriate treatment before it's too late.