- Cristiane Martins
- BBC News Brazil, London
1 hour
image source, Getty Images
Snoring is a sound produced by the vibration of the pharyngeal tissues caused by the narrowing of the muscles of the respiratory tract.
The causes are diverse: There are people who snore when sleeping on their back, following drinking alcohol or using medication, for example.
There are also those who snore due to anatomical changes, such as large tonsils and a narrow palate, or due to factors such as obesity, smoking, pregnancy and a history of allergic diseases.
“The change in sleeping position, the relaxation of the muscles during sleep and the possible points of narrowing determine a change in the air flow, giving rise to different noises – snoring – and even moments in which there is a total blockage of air intake, apneas,” Edilson Zancanella, president of the Brazilian Association of Sleep Medicine, coordinator of the sleep disorders service at the Hospital das Clínicas da Unicamp and director of the Brazilian Sleep Association, explains to BBC News Brazil.
It is estimated that regarding half of the world’s adult population snores, and one in 10 children does too.
“The snore is a warning sign, a symptom. In general, snoring is a sign that the airway is obstructed, reduced in size,” Luciane Mello, pulmonologist and researcher at the Sleep Institute, tells BBC News Brazil.
In addition to the direct and indirect effects, it is also necessary to investigate the existence of pathologies, such as obstructive sleep apnea, a blockage of the airways in the throat that causes the person to temporarily stop breathing (in severe cases it can even cause death).
However, while it might seem like snoring is normal, it’s not, experts say.
“Uncomfortable” company
It is common for a person to discover that they snore through another person, usually relatives or someone with whom they share the same space.
Often this companionship is uncomfortable, some seek treatment, and in some extreme cases even lead to separation from the couple.
It is worth remembering that men tend to snore more than women.
“This is because their pharynx is larger and has a greater capacity to collapse. Women begin to snore more following menopause, in the climacteric phase, due to the reduction of hormones such as estrogen and progesterone,” explains Danilo. Sguillar, coordinating otorhinolaryngologist of the Department of Sleep Medicine of the Brazilian Association of Otorhinolaryngology and Cervicofacial Surgery.
But snoring isn’t just a sign that something is wrong or leading to social problems with those who sleep nearby.
The physical, mental and social health of those who snore can also be greatly affected.
Associated with a restless night, poor sleep quality is linked to an increased risk of heart disease, stroke, depressive disorders, and other health-related problems.
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In some cases of apnea, doctors recommend the use of a CPAP machine.
What is snoring and what are its effects?
The anatomy of our upper airways is made up of the nose, pharynx, and larynx. And “snoring is nothing more than air whirling past a place where the upper airway is narrowed,” Sguillar explains.
With this narrowing, there is a reduction in air flow that impairs oxygenation during sleep, reaching total blockage in some cases (so-called apnea).
This noise can also be related to muscle flaccidity, changes in pharyngeal closure, hormonal changes and, often, the use of substances that cause greater muscle relaxation, such as alcohol, anxiolytics (medicines for anxiety disorders) and muscle relaxants.
Therefore, there are several possible causes. Neck anatomy, such as having a narrow or very long throat, enlarged tonsils, and adenoiditis, can also cause snoring.
The same happens with a history of allergic diseases (bronchitis, rhinitis, sinusitis, etc.), respiratory diseases that make it difficult to breathe through the nose, adenoids, deviated septum and even anatomical imperfections in the dental arch and use of a pacifier.
Not to mention the position in which you sleep: sleeping on your back can cause snoring because this position affects the position of the tongue inside the mouth, which is further back.
This picture is usually associated with bad nights sleep.
Sleeping well is an important factor for health and quality of life: it is during sleep that muscles relax, hormones are released and memory is strengthened.
In general, restful, restful sleep is uncomplicated and uninterrupted and lasts 7-9 hours for adults and 12-17 hours for children, according to the NHS.
On the other hand, the effects of a bad night’s sleep can appear the next day, compromising memory, concentration, reasoning and motor coordination.
Irritation, headaches, altered blood pressure are also the result of this. In addition to the medium and long-term effects, such as those mentioned above.
Diagnosis of factors surrounding snoring
First of all, it is important to emphasize that only a specialized health professional should diagnose and treat the cause of snoring.
Seeking care from an otolaryngologist or a doctor who specializes in sleep medicine is recommended. Treatment and diagnosis may also involve other health professionals, such as speech-language pathologists and dental surgeons.
The diagnosis is made in consultation with analysis of symptoms, detailed medical history of the patient and, if possible, accompanied by relatives or a partner if there is one, since this person can help a lot.
“We ask if eventually, along with this snoring, the partner or a partner observes an associated respiratory arrest,” explains Mello, from the Sleep Institute.
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Depending on the consultation, the doctor may order a laryngoscopy (an exam that evaluates the upper respiratory tract, such as the nose, pharynx, and larynx) or tests to diagnose sleep-disordered breathing (SBD), when there is an abnormal pattern of breathing asleep, which can cause snoring and even pauses in breathing at night.
Sleep assessment is done through a test called polysomnography, which is done while the patient is sleeping with sensors that help monitor snoring.
It’s fundamental observe the sleep of the snoring patient and evaluate the behaviorif there is agitation, nocturnal awakenings, difficulty breathing, snoring pattern, intensity, body position, etc.
Snoring may be associated with obstructive sleep apnea, “a worrying pathology that can have serious cardiovascular consequences, such as acute myocardial infarction, arrhythmia, stroke, and difficult-to-control hypertension,” according to Sguillar, of the Brazilian Association of Otorhinolaryngology and Cervicofacial Surgery.
What is obstructive sleep apnea?
A study published in the scientific journal The Lancet estimated that almost 1,000 million people in the world suffer from obstructive sleep apnea (OSA), a disease that is often ignored by patients and even by some doctors who do not pay attention to the patient’s sleep.
OSA is defined as the obstruction of the airways at the level of the throat, causing the person to stop breathing.
It is one of the sleep-disordered breathing disorders and is associated with snoring, but not everyone who snores has obstructive sleep apnea.
There are three types of apnea: central apnea, which is when there is no inspiratory effort, obstructive apnea, when there is inspiratory effort associated with the cessation of airflow, and mixed apnea, which is when both occur at the same time.
According to the Ministry of Health, when this happens it can last regarding 20 seconds, but there are cases of two minutes, and it can even happen several times during the same night.
Men are the most affected by obstructive sleep apnea, and 30% of them are over 50 years old. But children are also and can be affected by snoring, regarding 1% to 4% of children have obstructive sleep apnea.
Some studies claim that around 15% of overweight pregnant women suffer from obstructive sleep apnea. In cases where the pregnancy is high risk, the incidence can increase up to 60%, with impacts even for the baby.
Apnea occurs when there is a complete interruption of air: when the flow of air to the lungs decreases, the oxygen levels in the bloodstream are reduced and the patient wakes up.
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How to treat snoring?
Treatment depends on the cause and may involve multiple clinical departments and health professionals.
For those who snore little, low and on specific occasions, as in the case of a nasal obstruction due to the flu, for example, simply changing position while sleeping may be enough to alleviate or solve the problem.
This includes sleeping on your side and tilting your upper body with the help of an elevating pillow, for example, which can help keep your upper airways open (there are anti-snoring pillow options that a healthcare professional can recommend).
Also lifestyle changes are recommendedsuch as losing weight in the case of obese patients, quitting smoking and treatments for allergies and respiratory diseases (if this is the cause associated with snoring), practicing physical activities, keeping blood pressure under control and performing exercises that strengthen the structure of the throat
Treatment may also include nasal dilators, intranasal steroids, and adenotonsillectomy.
But all this can only be defined following diagnosis by a professional Of the health.
In moderate and severe cases, the use of a continuous positive airway pressure (CPAP) machine may be recommended, as it helps keep the airway open through a current of air.
It is worn with a mask attached to a tube, such as those used for inhalation, from which a stream of air flows into the throat and keeps the airway open at night. The type of machine and the air pressure must be indicated by the specialist treating the patient.
If none of these options resolve the problem, the specialist may consider surgery (called uvulopalatopharyngoplasty).
“The child may also have obstructive sleep apnea, and in those cases the indication of removal of tonsils and adenoids by the otolaryngologist is necessary,” says Sguillar.
“If there is a nasal obstruction, we often operate these patients to improve this nasal condition. It is a complement to this story, which we often also have to treat. Nasal obstruction with rhinitis sometimes causes night snoring and if we manage to treat rhinitis , we will improve snoring”, explains Mello, from the Sleep Institute.
“Many times we treat the airway with speech therapy, with specific speech therapy to strengthen the muscles, which helps in that snoring profile. But it all depends on the cause. We analyze each patient and evaluate which is the best strategy”, concludes the expert.
image source, Getty Images
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