snoring

What Causes Snoring?

Snoring is a general term for the sound that some people make while breathing during sleep.  There are many different types of snoring sound, but ultimately snoring comes vibration of structures inside the throat, most commonly the soft palate (back of the roof of the mouth).  At the most basic level, snoring occurs in some people because the muscles in the body relax during sleep, allowing these structures to vibrate as air flows by them.  When people are awake, these muscles are active, and the structures are much less likely to vibrate during breathing.

The causes of snoring are similar to those that cause a more-serious condition called obstructive sleep apnea.  About half of patients with snoring that regularly wakes up other people will have obstructive sleep apnea, and the difference between the two is that sleep apnea involves blockage of breathing in night.  Obstructive sleep apnea may be associated with health problems like high blood pressure or with disruption of sleep, leading to sleepiness and fatigue, so someone who is concerned about obstructive sleep apnea should speak with their medical provider about their snoring.

Is Snoring Caused by the Soft Palate Alone?

The short answer is No.  Everyone has a soft palate, but not everyone snores.  The soft palate may be the major source of the sound, but one essential part of snoring relates to the flow of air by the soft palate.  People that snore typically have air flowing through the nose and throat that is more turbulent, or uneven, than non-snorers.  This lack of smooth airflow is what enables the soft palate (or other structures) to vibrate and produce the snoring sound.  An important part of treating snoring is finding out what is preventing the smooth flow of air through the nose and throat to cause snoring; treatment can even focus on the nose if there is blockage of breathing there.

What About the Uvula?

The uvula is the rounded structure that looks like a punching bag as it hangs down in the back of the throat, off the end of the soft palate.  Nobody knows why we have one, but it seems like the uvula may serve two functions, based on what we see in individuals who have had their uvula removed.  The uvula may help to spread mucus and saliva over the back of the throat and keep everything moist, and it also may improve the aerodynamics of the breathing passages to help the smooth flow of air through the nose and throat.  As for snoring, it seems that an excessively long or thickened uvula can cause or at least contribute, so some patients can benefit from shortening of the uvula.

Are There Other Causes of the Sound of Snoring?

Absolutely.  Other structures that vibrate include the sides of the throat (also called the lateral walls) and even the epiglottis (a structure in the throat that prevents food and liquids from going into the lungs, among other functions).  The lateral walls and epiglottis likely contribute to snoring sound more often in people with obstructive sleep apnea, whereas the soft palate and uvula play the primary role in snoring in patients with and without obstructive sleep apnea.

Why Do Only Some People Snore?

The chances of snoring increase with a number of risk factors: trouble breathing through the nose or throat, being overweight or obese, the natural aging process, male gender, and pregnancy.

Because the nose is the first area of the breathing pathway, trouble breathing through the nose creates uneven airflow and can be a major cause of breathing.  Treatments—ranging from conservative options to medications to surgery—can open up the nasal passages and markedly improve or stop snoring completely.  There are other causes of blockage in breathing that increase the chances of snoring, such as enlarged tonsils or a small upper or lower jaw.  These may or may not require treatment, with the treatment choice based on determining the most important cause of the snoring.

People will realize that their snoring only started when they gained some weight, but the reason for this has become clearer recently.  The most likely explanation for the connection between weight gain and snoring is fat deposition around the throat that can occur with weight gain.  Whether due to genetics or another reason, some people are prone to depositing fat inside their tongue itself (https://www.ncbi.nlm.nih.gov/pubmed/25197815) and likely in other structures around the throat. The result is that the tongue and these other structures are physically enlarged and more likely to narrow the space for breathing (and contribute to turbulent flow of air through the nose and throat).

With the natural aging process, people develop skin wrinkles because there are changes occurring within the skin, such as the loss of collagen that gives skin its tightness.  It turns out that there are age-related changes occurring through the entire body.  Snoring is clearly more common with aging ( https://www.ncbi.nlm.nih.gov/pubmed/17767677), and it appears to be more than just a natural tendency for people to gain weight over time.

Men are more likely to snore than women—but snoring is common among women too!  Estrogen and progesterone both protect against snoring.  This explains why snoring is less common in women before menopause than in men but then increases after menopause to be similar to men, once you eliminate the influence of other factors like weight gain.  There are other reasons that may explain why men are more likely to snore, including the fact that men tend to have a longer neck and throat and therefore have a longer path for air to flow and cause vibration along the way.

Although women are less likely than men to snore, pregnancy is a time of increased snoring for women (https://www.ncbi.nlm.nih.gov/pubmed/16295215).  There are many causes, but the main ones seem to be the general weight gain and fluid retention (causing swelling) that occurs throughout the body.  Studies show that about half of pregnant women snore regularly during pregnancy, including many who did not snore before pregnancy and who will not snore after delivery.

Above by By Dr. Eric Kezirian


 

The Causes of Snoring Outlined

Do you wake up with a sore throat or is your mouth dry many mornings? Maybe your bed-mate routinely elbows you awake in the middle of the night. The problem could be snoring. May us of don’t even realize we snore unless someone tells us. But snoring may interfere with the quality of your sleep. The interruptions in sleep by a snoring partner can even put a strain on relationships and cause people to sleep in different bedrooms.

If you or a partner snore, you’re not alone. Snoring is very common. According to the American Academy of Otolaryngology, about 25 percent of adults snore habitually and as many as 45 percent snore at least occasionally. That percentage may increase in adults over the age of 50.

snoring

So, what gives? What causes snoring and does it always indicate a problem?  Snoring occurs when you cannot move air freely through your nose or throat while you’re sleeping. If your upper airway narrows during sleep, air must move through a smaller opening, which can cause the surrounding tissue to vibrate. That vibration results in noisy breathing.

The airway may be narrowed due to problems or conditions associated with the mouth, throat or nose. For example, large tonsils or flabby tissue in the back of the throat may obstruct the airway. In other instances, problems with the nose, such as a deviated septum or congestion from allergies can narrow the airway.

What causes snoring – Snoring risk factors:

  • Excess weight
  • Pregnancy
  • Structural abnormalities
  • Alcohol and other sedatives
  • Body position

Although anyone can snore, there are certain conditions that can increase your risk including the following:

  • Pregnancy: Nasal congestion is common during pregnancy, which can obstruct the airway and lead to snoring.
  • Obesity: Extra weight can contribute to excessive soft tissue in the neck. The extra tissue can lead to narrowing of the airway, which causes snoring.
  • Structural abnormalities: Certain structural deformities of the upper airway can lead to snoring. For example, a large tongue or tonsils can partially block the airway leading to noisy breathing.
  • Alcohol use before bed: When the muscles of the tongue or throat relax, they can obstruct the airway. Substances, such as alcohol, may cause the muscles to relax and contribute to snoring.

    Snoring Mouth Picture
    Snoring Mouth Picture

Although some people snore every night, others may snore only intermittently. That’s because the position you sleep in may affect whether you snore on any given night. When you sleep in a certain position, such as on your back, your airway is more likely to become obstructed. What happens is the muscles of your throat and tongue may fall to the back of your throat and interfere with normal airflow. If you sleep on your side, snoring is still possible. But the change in your position may open your airway. You can snore during any stage of sleep, but it may occur more frequently when you enter a deep sleep stage and are more relaxed.

Sleep Apnea and Snoring

Snoring is often a symptom of sleep apnea, especially heavy snoring. But not all people who snore have sleep apnea. It’s important to understand the difference between the two conditions to rule out a serious sleep disorder.

Keep in mind; snoring is noisy breathing due to vibrating tissues in the throat often occurring due to a partially blocked airway. Sleep apnea is also caused by a blocked airway. But the difference is sleep apnea also involves pauses in breathing due to airway obstruction. Not all people who snore have pauses in their breathing.

Although snoring can be a nuisance, it does not present the same risks as sleep apnea. Sleep apnea is associated with an increased risk of a heart attack, high blood pressure and a stroke. But even if you don’t have sleep apnea, treating snoring may improve sleep for you and your partner. Treatment options include lifestyle changes, dental devices and in some instances, surgery.

To silence snoring, your best bet is to talk with your doctor or a sleep specialist to determine the cause of your snoring and best treatment options.

References

American Academy of Otolaryngology. Snoring and Sleep Apnea. http://www.entnet.org/content/snoring-and-sleep-apnea   Retrieved January 2017.

American Rhinologic Association. Nasal Congestion and Snoring. http://care.american-rhinologic.org/snoring_nasal_congestion    Retrieved January 2017.

Author: MaryAnn DePietro, CRT is a medical writer and licensed respiratory therapist with over a decade of clinical experience.

Summary: Risk factors for snoring are outlined. Snoring causes and effects are described. Solutions for how to stop one from snoring.

 

 

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