Is snoring bad?
Gone are the days when snoring was considered a harmless behavior. While snoring can sometimes be harmless, it is frequently a warning sign of a much more dangerous condition, Obstructive Sleep Apnea (OSA). But even when OSA is not a cause, snoring can still lead to other health problems.
How common is snoring?
Snoring affects around 90 million adults, more than a third of them nightly. Women and children snore, despite popular opinion, though men are still more likely. And while even babies can snore, the most likely candidates for snoring are people between the ages of 55 and 64, according to data compiled by the National Sleep Foundation.
What causes snoring?
Snoring is the involuntary sound that occurs when the muscles in your throat naturally relax and your tongue recedes during sleep. This narrows the breathing passage, creating perfect conditions for noisy vibrations occurring during both inhaling and exhaling. The sounds can vary widely, from rattling and whistling to growls and groans, with comparisons made to chainsaws, motorcycle engines and wind tunnels. Some people may never snore, or if they do, they don't snore loudly.
The main causes of snoring include:
- Undiagnosed OSA, in which sufferers gasp for air, or make no noise at all, then begin to choke or clear the airway following pauses in breathing
- Anatomical problems with the airway (such as oversized adenoids)
- Being older; age softens muscle tone, leading to a "floppy" airway
- Sleeping supine (on your back), which creates conditions for snoring
- Obesity, as extra swelling and fatty tissue around the neck increase airway resistance
- Other medical conditions (i.e. pregnancy, allergies)
- Lifestyle habits: drinking or smoking (tobacco or marijuana) before bedtime, or sedatives taken at bedtime, all which encourage snoring
What are the consequences of untreated snoring?
Snoring can be a nightly nuisance or a random occurrence. However, even mild, intermittent snoring can have consequences.
Obstructive Sleep Apnea (OSA)
Snoring is a major indicator of Obstructive Sleep Apnea (OSA). It's estimated that about half of all loud snorers have OSA. When the upper airway is completely blocked during sleep for periods of 10 seconds or more, snoring is no longer snoring, but sleep apnea. When left untreated, OSA can cause, lead to or aggravate many serious chronic health issues. Severity and treatment can only be determined by a sleep test.
The upper airway resistance of snoring places major stress on the heart as you sleep, which leads to elevated blood pressure. Snoring can also lead to or aggravate preexisting arrhythmias, the most common variety known popularly as "A fib" (atrial fibrillation); while arrhythmias are common, they elevate concerns about heart health if sleep apnea is also indicated. Finally, the size of the heart may increase as it compensates for the ups and downs in stress hormones and oxygen levels caused by snoring; this generates a higher risk for heart attack or stroke.
If you have any level of resistance in your upper airway as you sleep, your body must work harder to maintain a healthy blood oxygen balance. Light snoring may not result in hypoxia (low blood oxygen), but loud and habitual snoring probably will. Hypoxia, when encountered frequently every night, can lead to pulmonary hypertension, which affects the vascular system in the lungs.
Morning headaches may be the result of snoring-induced hypoxia. Sore throats and coughing occur when airway resistance meets dry air. The gums and teeth can feel "spongy" in the morning, and stiff necks and jaws may be the result of snoring. In these instances, the brain has instructed the jaw to clench or the teeth to grind while you sleep to help maintain a more rigid airway so it won't collapse.
Also, gastroesophageal reflux disease (GERD) contributes to snoring problems due to pressure changes in the upper airway. These impact the ability of the esophagus to contain stomach acids. Aspirated digestive products that have risen into the throat can result in burning cough, laryngitis and wheezing.
Snoring left untreated leads to sleep debt, the accumulation of sleep deprivation that results in systemic changes to metabolism and the hunger drive. Eventually, dietary choices—caused by cravings for calories and carbohydrates inspired by sleep deprivation—with join a slower metabolic drive and problems with insulin resistance to generate extra pounds.
Many snorers wake themselves up snoring. No wonder they wake up unrefreshed; they often snore themselves in and out of quality sleep without even realizing it, and do not feel rested in the morning. These frequent awakenings send frequent floods of stress hormones into the bloodstream, causing sleep fragmentation. When this happens—especially during dream sleep—snorers experience "confusional arousal." Daytime performance is also impaired by sleep fragmentation. People who snore have problems with memory processing, attention deficit and concentration and endure strong drives to nap during the day (excessive daytime sleepiness).
Perhaps the biggest public health concern resulting from snoring is drowsy driving (of any kind of
vehicle, not just automobiles). Anyone who snores regularly may suffer enough nightly sleep disruption to be prone to errors in judgment behind the wheel. Not all drowsy drivers fall asleep at the wheel, but even they can be dangerous: they can have impaired reaction times, lose their ability to stay focused on the road and misread situations while in motion. Other dangerous outcomes for people who snore include making critical workplace errors, clumsiness and fall risks—all due to the side effects of ongoing sleep fragmentation caused by snoring. That same sleep fragmentation can also mean less alcohol tolerance, which leads to poor judgment about driving and less ability to resist risky behaviors afterward.
Sleep disruptions for non-snorers
Often the problem of snoring significantly impacts the sleep of a bed partner, or even an entire household, if the decibel level is high enough! Problems with daytime functioning and sleepiness also occur for these people. "Second-hand" sleep fragmentation (so-called Spousal Arousal) is no laughing matter; sleep disturbances for non-snorers threaten significant health issues for them, as well.
Solutions for snoring
There's no reason why anyone should suffer from snoring, given the multitude of solutions for successfully treating it.
Sleep hygiene and self care
- Humidify. For those who live in a dry climate, it's important to recognize that dry air can lead to swollen tissue and fewer secretions in the airway. The result? Snoring. Humidity can provide relief.
- Lose weight. Less fatty tissue around the neck means gravity and swelling are less likely to close the airway.
- Eat early and light. Large, late, high-calorie meals can lead to problems with GERD after midnight.
- Avoid drugs. Prescription or over-the-counter sleep aids, alcohol, tobacco, marijuana or any drugs that cause drowsiness can depress the respiratory system, making breathing even harder as you sleep.
- Change positions. This is a time-honored practice, especially among married couples who nudge their snoring partners to turn to their sides to stop the noise.
- Treat your medical concerns. If you have allergies, physiological problems (such as deviated septum), or are pregnant, ask your healthcare professional to help you manage these conditions.
- Use a medical device. CPAP therapy, which enlists a mask and controlled air pressure to keep the airway open, can be useful for heavy snoring. Oral devices temporarily reposition the jaw to allow more space for breathing. Other devices such as nasal dilators are new to the market and may offer some relief, over the counter.
- Consider surgery. For some, reducing the size of the tongue, removing the adenoids or correcting a sinus cavity blockage can help.
Bottom line: Have snoring checked out
If you have been told you snore, don't assume it's harmless; check out the symptoms listed above. Do they sound familiar? Don't be shy about seeking a medical opinion. It might be the best medical decision you ever make, given the consequences of leaving it untreated.
Also, find ways to convince your sleeping partner or loved one to have their snoring checked out. This may be easier said than done, but here are some strategies that might work.