snoring

Snoring is a condition in which there is a hoarse or abnormal sound while breathing while sleeping. It is caused by a partial blockage of the airway and snores louder when lying on the back. Mild snoring can be relieved by changing behaviors, such as sleeping on the side and avoiding drinking alcohol before going to bed. Snoring affects both the health of the snorer and disturbs the person sleeping next to him. Snoring is more common in men and becomes more severe with age.

Snoring

Snoring usually occurs during deep sleep and is louder when lying on the back. The sound is produced in the throat area during inhalation while sleeping. It occurs more in men than in women. Most people who snore often have a combination of airway obstruction and internal organs in the throat vibrating. The sound produced varies depending on the location of the vibrating organ. For example, if the soft tissue at the back of the nasal cavity vibrates, it will create a nasal sound. If the soft palate or uvula vibrates, it will create a louder sound in the throat.

The severity of snoring is divided into 3 levels as follows:

• Severity level 1 is general snoring, not frequent and not very loud. Snoring at this level does not affect breathing while sleeping, but it may affect the relationship of the person sleeping next to you.
• Level 2 severity snoring is frequent or occurs more than 3 days per week. This level of snoring may cause mild to moderate breathing while you sleep and cause daytime sleepiness and fatigue.
• Level 3 is frequent, loud snoring. This level of snoring is often accompanied by sleep apnea, which can partially or completely block the airway for about 10 seconds, resulting in insufficient oxygen to the brain and affecting daily life.

Obstructive Sleep Apnea (OSA) is a sleep disorder that is often associated with and occurs in people who snore. See your doctor if you experience any of the following symptoms along with snoring:

• Snoring loudly
• Very sleepy during the day
• Morning headache
• Dry throat, sore throat
• Decreased concentration and memory
• Restless sleep
• Choking or chest pain at night
• High blood pressure

Causes of snoring

Snoring is the result of a narrowing or blockage of the upper airway, which can occur for a number of reasons, including:

• Obstructed nasal airway is found in patients  with allergies , sinusitis, nasalpolyps  , or those with abnormal nasal structures such as a deviated septum.
• The tongue and throat muscles relax, pulling back to block the airway. This occurs in people who are deep sleepers, those who drink a lot of alcohol, especially near bedtime, those who take sleeping pills, and the elderly.
• Large neck tissue is found in obese people, overweight people, people with a thick neck or people with a neck circumference of more than 43 centimeters, people with enlarged tonsils or adenoids.
• A long soft palate or uvula narrows the airway behind the nose and throat. When the soft palate or uvula vibrates or collides, it blocks the airway.

Diagnosis of snoring

Generally, snoring is a symptom that the patient has noticed by themselves or people around them have already noticed. They should see a doctor for further diagnosis. For examination in the hospital, the doctor will diagnose from the symptoms of the snorer or examine the body. If the doctor suspects that it is caused by an abnormality in the mouth of the snorer at a mild level, in order to find a way to treat it. Or for those who snore at a severe level, the doctor may have other diagnostic approaches as follows:

• X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) scans to check for abnormalities or structures of the airway.
• Sleep Health Examination ( Sleep Testor Polysomnography) The doctor may diagnose this method depending on the severity of snoring, health problems or other sleep problems. You may have to stay overnight in the hospital for sleep study and analysis by a specialist. There will be equipment or devices installed to detect and record various body signals such as brain waves, heart rate, breathing rate, blood oxygen level, sleep stages, eye movements, leg movements while sleeping, etc.

In addition, doctors may recommend that patients do a home sleep test. The principle of the machine is to detect oxygen levels and other values ​​during sleep. The data will then be sent to a specialist to evaluate the results as a graph and the doctor will diagnose the data again. This method is another alternative diagnosis that may help reduce the burden on patients in various aspects, such as saving some treatment costs, not having to stay in the hospital , or sleeping more soundly because they are sleeping in a familiar place, etc.

However, each method of examination has its own advantages and disadvantages. Before deciding to undergo any treatment, you should consult a sleep specialist so that the doctor can assess and recommend the correct treatment method.

Snoring treatment

Initially, the doctor will recommend behavioral changes for those who snore at a mild level, such as losing weight, avoiding drinking alcohol, especially before going to bed, changing sleeping position from lying on your back to lying on your side, etc. For those who snore severely or have snoring caused by sleep apnea, the doctor may have the following treatment guidelines:

• The use of anti-snoring devices is used when snoring cannot be relieved by behavioral modification, such as:
  • Nasal snoring devices to help increase the airway space in the nose, such as nasal strips, which are small pieces of tape that are placed on both sides of the nostrils.
  • Oral anti-snoring devices, such as chin strips, are strips or tapes that are placed under the chin to prevent opening the mouth while sleeping.
  • A mandibular advancement device (MAD) can increase the space at the back of the throat and prevent narrowing of the airway, which can cause the tongue to vibrate during breathing and cause snoring.
• Surgery is used when snoring cannot be relieved by behavioral modification or the use of anti-snoring devices, such as:
  • Uvulopalatopharyngoplasty (UPPP) is a surgical procedure that tightens the soft palate, uvula, and pharyngeal wall. In some cases, the tonsils and adenoids may also be removed. This may cause slurred speech after surgery or other serious side effects that may occur in about 1% of patients, such as excessive bleeding, lung infection, heart failure, and cerebrovascular disease.
  • Laser-Assisted Uvulopalatoplasty (LAUP) is another option, but in the long term, it may not produce as good results as surgical tightening of the soft palate, uvula, and pharyngeal wall.
  • Soft palate surgery to strengthen the soft tissue and reduce vibrations during sleep can be performed in several ways, such as radiofrequency ablation (RFA), which uses radio waves to strengthen the tissue, or a pillar procedure, which injects synthetic polyester fibers into the soft palate.
• Use of medication to treat the underlying cause of snoring, such as antihistamines to relieve nasal swelling and irritation from allergic rhinitis, or nasal decongestants, but should not be used continuously for more than 7 days as it may make symptoms worse.

Complications of snoring

Snoring not only causes annoyance to the person sleeping next to you, but it can also cause health problems, such as sleep apnea and other complications as follows:

• Pauses in breathing, lasting from a few seconds to minutes, while you sleep, are caused by a partial or complete blockage of the airway.
• Not sleeping well, waking up many times in the middle of the night, whether consciously or unconsciously, causing sleepiness during the day, affecting life and driving efficiency.
• Risk of high blood pressure, heart disease, and stroke if you have sleep apnea for a long time.

Snoring prevention

Mild snoring can be relieved and prevented by making behavioral changes and following these guidelines:

• Losing weight, especially if you are overweight, can help reduce snoring.
• Sleeping on your side. Sleeping on your back increases the chances of your tongue blocking your airway. To fix this, try sewing a small pocket into the back of your nightgown and stuffing a tennis ball in it if you’re worried about falling back to your back while you sleep.
• Sleep on a high pillow, using a pillow to raise your head about 4 inches.
• Using nasal strips or a nasal dilator while sleeping can help increase the airway space in your nose, making breathing easier.
• Reduces nasal airway obstruction. In patients with allergies or deviated nasal septum, breathing through the nose is inconvenient and requires mouth breathing, which increases the chance of snoring.
• Reduce or avoid alcohol consumption for at least 2 hours before bedtime, or avoid sleeping pills and sedatives to reduce the chances of relaxing the muscles in your throat and blocking your airway.
• Quit smokingbecause smoking causes nasal congestion and difficulty breathing.
• Get enough sleep. Preschoolers should sleep about 11-12 hours a day, school-aged children should sleep at least 10 hours a day, teenagers should sleep about 9-10 hours a day, and adults should sleep at least 7-8 hours a day.