Sleep disorders, including snoring, sleep apnea, insomnia, and sleep deprivation are common. Forty-five percent of normal adults snore at least occasionally, and 25 percent are habitual snorers. Problem snoring is more frequent in males and overweight persons, and it usually grows worse with age.
What Causes Snoring?
The noisy sounds of snoring occur when there is an obstruction to the free flow of air through the passages at the back of the mouth and nose. One thing to remember from the outset is that the cause of your snoring is likely to be multifactorial.
People who snore may suffer from:
- Poor muscle tone in the tongue and throat. When muscles are too relaxed, either from alcohol or drugs that cause sleepiness, the tongue falls backwards into the airway or the throat muscles draw in from the sides into the airway. This can also happen during deep sleep.
- Excessive bulkiness of throat tissue. Children with large tonsils and adenoids often snore. Overweight people have bulky neck tissue, too. Cysts or tumors can also cause bulk, but they are rare.
- Long soft palate and/or uvula. A long palate narrows the opening from the nose into the throat. As it dangles, it acts as a noisy flutter valve during relaxed breathing. A long uvula makes matters even worse.
- Obstructed nasal airways. A stuffy or blocked nose requires extra effort to pull air through it. This creates an exaggerated vacuum in the throat, and pulls together the floppy tissues of the throat, and snoring results. So, snoring often occurs only during the hay fever season or with a cold or sinus infection.
- Also, deformities of the nose or nasal septum, such as a deviated septum (a deformity of the wall that separates one nostril from the other) can cause such an obstruction.
Obstructive Sleep Apnea
Obstructive sleep apnea is a relatively common condition which is thought to affect 2-4 % of middle aged men and 1-2% of middle aged women.
In people who have the condition there is repetitive collapse of the airway throughout the night at the level of the throat. Airway closure in turn leads to a brief awakening (termed an arousal) and the brain then activates the muscles necessary to hold the airway open while the lungs take two or three large breaths before the airway collapses again. Episodes of airway closure may occur frequently: in the most severe patients this may be more often than once every minute. Frequent awakening through the night causes daytime tiredness in some but not all patients.
Obstructive Sleep Apnea is associated with a number of medical conditions including high blood pressure, coronary artery disease, stroke, erectile dysfunction and insulin resistance. Because these conditions are common in the overweight and because weight is a strong predictor of Obstructive Sleep Apnea it is not yet known whether OSA contributes to them or if they are all consequences of being overweight. For this reason it is unclear whether Obstructive Sleep Apnea patients who are not sleepy need to be treated.
The most information is available for high blood pressure: we know that patients with Obstructive Sleep Apnea patients left untreated have an increased risk of developing high blood pressure and we know that treatment of sleepy, but not non-sleepy, patients reduces high blood pressure. Deciding whether to have treatment for Obstructive Sleep Apnea will require discussion with a sleep specialist and will depend in part on how severe the Obstructive Sleep Apnea is.