Snoring : Causes, Types, Treatment and Symptoms

Snoring is a noisy breathing sound caused by the vibration of soft tissues on the back of the throat and nose during sleep due to a partially blocked airway. While occasional snoring is normal, loud or persistent snoring may indicate an underlying health issue such as obstructive sleep apnea (OSA).

Most common snoring symptoms:

• During sleep:
  – Gasping, snorting or choking sounds during sleep
  – Sleep restlessness, causing twisting and turning frequently
  – Temporarily stopped breathing while asleep
  – Loud, frequent and disruptive snoring 
• While awake:
  – Excessive daytime sleepiness
  – Morning headaches upon waking up
  – Waking up frequently or having difficulty sleeping or staying awake
  – Temperamental behavior or mood swings
  – Dry mouth or sore mouth
  – Trouble focusing on a task or retaining memory
  – Impaired cognitive function

Common, Uncommon or Underlying Causes of Snoring

While the most common causes of snoring arise from natural body changes, lifestyle, and anatomical factors that lead to the narrowing or relaxation of the airway during sleep, loud and persistent snoring can indicate a more complex medical or physiological condition.

• The excessive relaxation of the throat muscles occurs in a state of deep sleep due to being overly tired.
• Allergies, colds, or sinus infections can block the nasal passages and force mouth breathing
• Sleeping on the back can cause the tongue and soft palate to fall backwards
• An extra layer of fat around the neck may collapse or narrow the airway
• Natural decrease in the throat muscles as age progresses
• Consuming alcohol or taking sleeping pills
• Anatomical factors like a deviated septum (deviation of the walls separating the nostrils), unusually long uvula or thick soft palate, and enlarged tonsils in children.
• Hypothyroidism causes puffiness in the face, enlarged tissue in the throat, and a hoarse voice.
• Obstructive Sleep Apnea (OSA): Complete or frequent blocking of the upper airways multiple times in a sleep session
• Pregnancy or smoking
• On rare occasions, a tumour in the throat or voice box

When to Seek a Specialist for Your Snoring?

It is advisable to seek consultation with a sleep medicine specialist, otolaryngologist, or primary care provider (PCP) regarding your snoring, particularly if it persists, is loud, or is associated with additional symptoms indicative of an underlying health concern, notably obstructive sleep apnea (OSA). While occasional, mild snoring is generally commonplace and harmless, persistent and disruptive snoring may serve as an indication of a serious medical condition.

• A partner witnesses your breathing constantly stopping and starting throughout the night.
• Excessive daytime sleepiness (EDS) – fatigue, irritable or groggy during the day.
• Lack of concentration and memory problems hinder daily activities
• Gasping or choking for air in your sleep
• High blood pressure

Don’t wait for signs to grow severe. Consult our ENT specialists today

Diagnostic Approach for Snoring

The diagnostic approach for snoring begins with a detailed medical history and physical examination, followed by further testing that primarily confirms whether the snorer has benign snoring or a sleep disorder, like obstructive sleep apnea (OSA)

• Patient and partner history: identifying sleep positions and recording snoring characteristics.
• Physical examination: facial and jaw structure assessment, upper airways nd nasal passageway inspection.
• Imaging tests: X-rays, CT scans or an MRI
• Drug-induced sleep endoscopy (DISE): visualizing the vibrations and collapse of the upper airway diagnosed through an endoscope when the patient is under light sedation
• Polysomnography: a sleep study to monitor brain waves, heart rate, breathing patterns, eye and leg movement, and blood oxygen levels, to calculate Apnea-Hypopnea Index (AHI) and determine the severity of sleep

Types of Snoring

There are many ways to classify snoring, but the most common ones are by the source of the vibration, its severity, or whether it indicates a health issue.

Some common types of snoring include:

1. 1. Based on the source of vibration:
      – Nasal snoring – a whistling sound caused by nasal congestion due to allergies or a deviated septum.
      – Mouth snoring – the person inhales through the mouth with a louder and rattling sound at the back of the throat.
      – Tongue snoring – a high-pitched, inconsistent sound heard while sleeping on the back or after consuming alcohol.
      – Throat snoring – the most concerning and loudest type of snoring, occurs when the throat tissues collapse partially or completely.
   2. Based on medical significance:
      – Primary (benign) snoring – only challenging to the bed partner, with no significant health issues risk to the snorer.
      – Obstructive sleep apnea (OSA) snoring – snoring with multiple sessions of breathing cessation, choking.
   3. Based on sleeping position:
      – Back-positional snoring
      – Multi-positional snoring
   4. Based on severity:
      – Mild snoring – as loud as a quiet conversation.
      – Moderate snoring – resembles a low-speed car passing by.
      – Severe snoring – as loud as a vacuum cleaner heard from across the room.

How to Treat Snoring Symptoms?

Snoring treatments vary by cause and severity, ranging from simple lifestyle changes for mild cases to medical devices or, as a last resort, surgery for more persistent or severe issues. When snoring is a symptom of obstructive sleep apnea (OSA), a doctor’s diagnosis and specific medical treatment are essential.

For underlying causes, treatments & management strategies include:

• Adjust sleep position
• Maintain a healthy weight
• Try to sleep on your side
• Treat nasal congestion with a decongestant, nasal spray, or nasal strips
• Avoid alcohol and sedatives for a few hours before bedtime
• Use a humidifier to counter a dry nose and throat
• Myofunctional therapy – perform throat exercises to strengthen its muscles
• Continuous positive airway pressure – a golden standard to keep the airway open
• Custom-fitted dental mouthpiece – to hold the jaw, tongue and soft palate in place
• Uvulopalatopharyngoplasty (UPPP) – removal of the excess tissue from the throat, including the uvula and soft palate. It is a more invasive procedure with a longer recovery time.
• Laser-assisted uvulopalatoplasty – shrinks or tightens the tissues of the soft palate
• Septoplasty and turbinate reduction – correcting a deviated septum or reducing the swelling on the inner structures of the nostrils.
• Pillar procedure – tiny implants are placed into the soft palate.

What If Snoring are Left Untreated?

Some possible complications of an untreated snoring include:

• Cardiovascular issues: Repeated drops in blood oxygen due to sleep apnea can stress the cardiovascular system, increasing the risk of conditions like high blood pressure, heart attack, and stroke.
• Metabolic disorders: Type 2 diabetes, persistent snoring associated with OSA, and an increased risk of developing insulin resistance.
• Unproned accidants: untreated OSA daytime sleepiness, increasing the risk of motor vehicle and workplace accidents.
• Cognitive decline: Long-term sleep disruption and oxygen deprivation increase the risk of memory loss, cognitive impairment, and dementia.
• Depression, anxiety, and mood swings: due to the emotional toll and chronic lack of quality sleep.
• Daytime fatigue and sleepiness
• Disturbed sleep for partners: Increases conflict and reduces intimacy, putting a strain on the relationship.
• Other conditions that might be linked to persistent snoring associated with OSA.

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