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The big snore

Tips for silencing the roar

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What is snoring?

Snoring is noisy breathing during sleep. It can happen when you are breathing in or breathing out.

How does it occur?

Snoring occurs when air cannot flow smoothly through your air passages. Structures in your air passages vibrate while you breathe. Some causes of snoring include:

Sleeping on your back: Sleeping on your back allows your tongue to fall backward into your throat. Your tongue then partially blocks your throat, making a smaller passage for air.

Having a blockage in your nose: A blockage can occur from allergies, a common cold, or a sinus infection. It can also happen after an injury that changes the shape of your nose or nasal passages. Allergies can cause enlargement of your adenoids (tonsillike tissue at the back of your nose, where the nose joins the upper throat). Enlarged adenoids can cause snoring by blocking your airway and vibrating while you breathe.

Gaining weight: Gaining a large amount of weight can also cause or worsen snoring. The air passages become smaller by the accumulation of fat under the tissue lining the airway and by the increased pressure of a heavy chest on the airways.

Using some types of medicine or alcohol: Using drugs that cause excessive relaxation or sleepiness can also cause snoring. These drugs include alcohol, sleeping pills, antihistamines, and pain medicine (especially narcotics). The drugs relax your muscles and cause the tongue to fall backward. Relaxed throat muscles may draw in from the sides and narrow the airway.

Having sleep apnea: The problems that cause snoring can also cause a sometimes dangerous condition called sleep apnea. Sleep apnea affects between two and 10 per cent of people. It is more common in men than in women. It is also more common in people who are overweight, but there are many people with normal weight who have sleep apnea.Other possible causes of sleep apnea are:

  • tobacco smoking;
  • drinking a lot of alcohol;
  • lung disease; or
  • an abnormal sleep pattern because of an irregular work schedule or rotating shift work.

Some people inherit a tendency to have sleep apnea. Having sleep apnea means that you have periods of no breathing, sometimes as long as 30 seconds, when you are sleeping. This can happen many times during the night. It often interrupts your sleep and can prevent you from getting good-quality sleep. These periods of no breathing cause you to get less oxygen and can sometimes have fatal complications, such as heart rhythm problems. Symptoms of sleep apnea include being tired all the time, and often falling asleep during the day. Many people who snore do not have sleep apnea, but nearly everyone who has sleep apnea snores. If you snore and feel you do not usually get a good night's rest, you should ask your health-care provider if you might have sleep apnea.

How is snoring treated?

If there is an obvious cause of the snoring, then treating the cause often helps reduce the snoring. Possible solutions include:

  • Losing weight
  • Using medicine to unclog your nasal passages
  • Sleeping on your side or stomach
  • Having no alcohol before bedtime

Sometimes raising the head of the bed or mattress can help prevent snoring. This should be done by making the top of the mattress or bed frame higher than the foot of the bed. Do not use more pillows, which can kink your airway and cause more breathing problems.

Simple non-prescription devices called nasal strips are available at pharmacies. A nasal strip is a piece of plastic that puts slight pressure on the bridge of the nose and is held in place by an adhesive tape. It helps keep your nasal passages open during sleep. Many people find nasal strips helpful, but they are relatively expensive because a new strip must be used each night. They might be a solution for special occasions.

Ask your health-care provider for additional help with your snoring or sleep problems.

How long will the problem last?

How long the snoring problem lasts depends on the reason for the snoring. If the cause is temporary, such as seasonal allergies or drinking alcohol, there will be periods of time when you do not snore. If, however, it is due to the shape of your nose or throat, it may be a permanent problem unless it can be fixed surgically.

How can I help take care of myself?

See your health-care provider for a careful history and physical to find out if you have any easily fixable causes of snoring and, most importantly, if you need to be tested for sleep apnea. Follow your provider's recommendations and check back to report the results of each suggested treatment. Only by knowing what works and what doesn't work can your provider help you lessen or eliminate the problem.

Sleep apnea can be hard to diagnose because the symptoms may be very subtle or you may think your snoring and fitful sleep is just normal for you. Sleep apnea, however, can be part of a vicious cycle with obesity. Obesity can cause sleep apnea, and sleep apnea often causes or worsens obesity because you may eat to stay awake during the day. Your healthcare provider may:

  • Ask you about your health history and your family's health history.
  • Examine you, especially your throat and nasal passages.
  • Order blood tests, including a check of the function of your thyroid gland.
  • Do a sleep study at a sleep disorders clinic or sleep lab. Your heart rate, brain waves, chest movement, and blood oxygen levels will be measured while you sleep. The study will help determine if the movement of air slows during sleep or if your air movement stops completely during sleep. It will also show how often this happens during sleep.

What is the most common treatment for sleep apnea?

The most common treatment for sleep apnea is use of a machine that sends pressurized air into your nose and throat at night. How much pressure you need is determined by the sleep study. Your health-care provider will carefully supervise your use of this breathing machine because minor adjustments may need to be made so it works right for you. This treatment is called continuous positive airway pressure (CPAP). Surgery may be an option if you cannot use the breathing machine regularly and properly. A surgical treatment might include changing the position of the air passage in the nose or removing the tonsils.

Audra Kolesar is a registered nurse and manager with Health Links - Info Santé, the Winnipeg Health Region's telephone health information service.

The information for this column is provided by Health Links - Info Santé. It is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health-care professional. You can access health information from a registered nurse 24 hours a day, seven days a week by calling Health Links - Info Santé. Call 788-8200 or toll-free 1-888-315-9257.

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