Mild, moderate, or severe snoring that is either regular or episodic affects roughly 90 million people in the United States. At least 30% of adult Americans snore.
Snoring occurs during sleep and is characterized by barely noticeable or noisy breathing caused by vibrating respiratory tissues when breathing is obstructed. Many people are reticent to talk about social snoring, which describes how noisy snorers may disrupt the peace and/or sleep of family members or significant others. Most snorers do not know they snore unless someone tells them or until a resultant condition develops that requires medical attention. Social snoring and/or medical complications are what usually compel people to seek snoring solutions.
Snoring Risk Factors
Snoring is one of the most commonly reported sleep disturbances among adults. Snoring incidences tend to increase with age. An estimated 50% of middle-aged men and 30% of middle-aged women snore. Yet, snoring is most prevalent among 60% of men and 40% of women between the ages of 60 and 65. The risk of snoring loudly and disruptively on a recurrent basis increases with age. Although males snore similarly to females with regards to intensity, the male anatomy increases snoring risk, as there is a greater concentration of fat around the neck and abdominal regions than for most females.
For women over 50 years old, excess concentrated fat becomes an issue, while plummeting estrogen levels during menopause also increases snoring risk. Snoring is less prevalent among postmenopausal women who take hormone replacement therapy (HRT). Pre-menopausal women who experience irregular menstruation cycles and acutely fluctuating estrogen levels are at a higher risk of snoring than are women who experience a less erratic menstruation cycle.
A surge in hormones is an ostensible reason for higher incidences of snoring among women during pregnancy, especially during the 3rd trimester. Approximately 20% of all pregnant women snore. Hormone imbalances can lead to nasal congestion and swelling, while excess weight that pregnant women experience may add greater pressure to the abdomen (and diaphragm) and neck regions.
Certain foods and allergens may induce inflammation and nasal congestion that can lead to snoring. Casein protein in dairy products and gluten protein in wheat may cause mucous membrane flare-ups in the gastrointestinal and respiratory systems. Taking muscle relaxants and drinking alcohol before bedtime also increase snoring risk.
What Happens When You Snore?
The air that you breathe in and out of the nose and mouth travels through the mucous membrane-lined pharynx. When you sleep, muscles relax and respiratory structures of and around the nose, mouth, and throat are less taut. At the same time, breathing in generates low pressure that can push the walls of the pharynx further inward. Circumstances that, either individually or collectively, restrict the flow of air include:
- Relaxed muscle near respiratory tissues
- Slack respiratory structures
- Collapsed walls of the pharynx
- Inflamed respiratory tissue
- Fatty deposits that line upper airways
- A lax tongue that falls backwards
- Dilated adenoids and tonsils
- A weak throat that narrows during sleep
If the airway in the pharynx is too restricted, the soft tissue in the rear of the roof of the mouth vibrates and produces a boisterous sound. In severe cases, blockage can suspend breathing—a phenomenon that describes obstructive sleep apnea. Snoring intensity increases as sleep apnea worsens. However, intense snoring followed by an abrupt stop is a sign that the air pathway is completely obstructed. Pauses in breathing can last for seconds or several minutes multiple times throughout the night. Apnea sufferers often cough or snort once breathing resumes. Loudness of snoring does not confirm sleep apnea, nor does it indicate apnea severity or intensity.
To best understand the immediate and long-term ramifications of snoring, researchers customarily analyze snoring according to either subjective or objective criteria. Subjective snoring is based on a listener’s perception and snoring’s impact on family members and partner relationships. Social snoring is poorly addressed in most American households, and it can put a serious strain on interpersonal relationships. Together with chronic snorers, cohabitants can suffer the sometimes devastating psychological and physical damage of sleep deprivation that snoring often causes, including:
- Drowsiness during the day
- Compromised reflexes which increases the risk of accidents
- Lack of concentration
- Poor sex drive
- Anxiety and depression
Objective snoring analysis considers snoring sound intensity, snoring prevalence over a specific time duration, and snoring frequency during a sleeping session—all variables which can be assessed through quantifiable means, including acoustical measurement. However, scientific scoring standards and phraseology for principal or incidental snoring events have yet to be established—which hinders concerted efforts to explore the more accurate social and clinical impacts of snoring.
Nevertheless, researchers highly suspect that snoring may be a sign for or cause of serious medical complications, including obstructive sleep apnea, heart disease, and diabetes. Sleep apnea restricts oxygen, which impairs metabolic function and can lead to death in severe apnea cases. Pregnant women who snore are at higher risk of delivery complications. A chronic lack of oxygen can lead to low birth weight for their newborns.
A 2017 study in the journal Sleep Breathing suggests that loud and heavy snoring vibrations may trigger inflammation in body tissue and cause endothelial damage. Endothelium is body tissue that lines organ and other structural cells. A 2014 study suggested a link between women who snore and increased arterial wall thickness. The same study revealed a correlation between snoring and increased risk of carotid atherosclerosis. Snoring increased the risk for left ventricular hypertrophy (LVH), according to a 2016 study conducted in China. Daytime sleepiness from sleep deprivation and/or snoring were significantly implicated for future cardiovascular risk among older adults, in a 2013 article published in the journal Sleep.
The International Journal of Environmental Research and Public Health published evidence that moderate, strong, and very strong snoring intensity levels were associated with dyslipidemia among adults with a higher than normal body mass index. A heightened frequency of snoring as well as subsequent awakenings and breathing disruptions were associated with increased risk of metabolic syndrome, including diabetes, in a 2017 study that also emphasized the need for more standardized objective measurements when probing the causative aspects of snoring.
Research published in the journal Sleep suggests that snoring is associated with chromosomal leukocyte telomere attrition. Telomere length is an indicator of biological aging, and an attenuated length may be a marker of compromised immunity and age-related disease.
What Can I Do to Stop Snoring?
If you suspect that you are snoring or you have observed snoring symptoms in a cohabitant, you should consult a physician or sleep specialist. Snoring symptoms can appear mild, but they may indicate more serious problems.
Rule out certain lifestyle causes of snoring: limit alcohol consumption and eliminate cigarette smoking. Maintain a healthy diet, since fatty foods and allergens can cause congestion and obesity, which can induce or aggravate breathing problems. Head-positioning pillows and sleeping on your side can significantly alleviate positional causes of snoring. Specialists may suggest neuromuscular exercises that address respiratory structure impairments. Some medications may combat congestion problems that induce snoring. Consult your physician before taking any pharmaceuticals or over-the-counter medications.
Oral devices and face masks help open breathing pathways in mild-to-medium cases of snoring, but these appliances can be noisy and cumbersome. Oral devices can cause tooth damage if the device is not fitted properly. In extreme snoring cases, tissue-removal surgery (e.g., uvulopalatopharyngoplasty) is a risky option because further damage of the remaining tissue may develop over time, which may prompt the need for more invasive surgery. Radiofrequency ablation (RFA) is a new surgical procedure that applies radiofrequency energy to the back of the throat. The healed scarring in the localized area strengthens pharynx structures. RFA is a one-hour outpatient procedure that can greatly reduce snoring severity.
Here are snoring solutions you can discuss with your physician or sleep specialist:
- Healthy diet
- Maintain normal weight
- Head-positioning orthopedic pillows
- Sleeping on one side
- Neuromuscular treatment
- Oral devices and face masks
- Surgery (e.g., uvulopalatopharyngoplasty, radiofrequency ablation)