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Am Fam Physician. 2002;65(2):238-239

What causes snoring?

When you sleep, the muscles in your throat relax. This lets the airway partly close. Air then has to move faster through the narrower passage. This causes the palate and tongue to vibrate. We hear this vibration as snoring.

What are the problems with snoring?

People who snore may feel sleepy during the day because snoring can cause you to wake up for a few seconds many times during the night. This disrupts your sleep. Snoring can also seriously disrupt the sleep of your bed partner.

What is obstructive sleep apnea?

Obstructive sleep apnea (OSA) is a condition that causes a person to stop breathing while they sleep (this is called an apnea) for 10 seconds or longer, for about 10 or more times during every hour of sleep. These episodes of apnea often last for 30 seconds and even up to 1 minute. This can happen because the airway completely closes. Following the apnea, gasping or grunting occurs when breathing begins again. Often, people with OSA wake briefly at the end of each apnea when they start breathing again. They go right back to sleep without realizing that anything happened.

How do doctors diagnose OSA?

You should be evaluated in a sleep disorders unit by a polysomnography study. You will sleep overnight in a quiet room. You will have some wires or small sensors connected to your body. They will record different physiologic measures during sleep. Your snoring will be evaluated. The number of apneas will be counted. Doctors will be able to tell how severe your condition is.

What conditions can cause snoring and OSA to become worse?

  • Upper airway problems, including nasal blockage, a large tongue and enlarged tonsils, a long and wide uvula (the small, fleshy part that hangs from the roof of your mouth) and abnormalities of the jaw

  • Obesity

  • Use of alcohol

  • Sleeping on your back rather than on your side

What are the problems with OSA?

People with OSA often feel very sleepy during the day especially when they're inactive, like when watching TV or reading. Excessive daytime sleepiness can cause people to fall asleep at their desk or during a meeting, to be forgetful and to have trouble thinking clearly.

People who have OSA are much more likely to have a motor vehicle crash than other people. OSA can cause medical problems.

What medical problems can OSA cause?

OSA can cause high blood pressure (also called hypertension). High blood pressure increases your chances of having a heart attack or stroke. Treating OSA can reduce your high blood pressure.

How are snoring and OSA treated?

If you are overweight, you should lose weight. But some people who are thin also snore and have OSA. Not all overweight people snore or have OSA.

If you smoke, you should stop. You should not drink alcohol, especially before going to bed. You should not use sleeping pills and tranquilizers. You should try not to sleep on your back. You should try to get enough sleep every night.

There are no medicines that can treat snoring. But your doctor can prescribe several treatments for snoring and OSA. They are:

  • Continuous Positive Airway Pressure (CPAP). An air pump moves air through a nasal mask you wear when you sleep. It is very effective and is the best treatment for many patients with mild OSA and most patients with moderate to severe OSA. It might take a few days to get used to wearing the mask.

  • Position therapy (avoiding sleeping on your back). Many people with OSA have more breathing problems when they sleep on their back. If you're one of these people, not sleeping on your back can be an effective form of therapy. Your doctor can show you how to use “the tennis ball technique.” In this technique, you wear a cloth belt with a tennis ball placed in it near the middle of your back to remind you not to sleep on your back.

  • Oral devices. These devices are like plastic football mouthpieces. You put them in your mouth at bedtime to keep your tongue and jaw forward during sleep.

  • Surgery. It is always important for you to have an ear, nose and throat evaluation. A number of surgical procedures are available. Unfortunately, surgery is not always helpful. Before deciding to have surgery, you should discuss it with a sleep specialist. You should find out all the pros and cons of any surgery.

Why is it important to treat OSA?

Treating OSA will stop snoring, breathing pauses, and excessive daytime sleepiness. You should probably feel better in a few days. You won't feel so sleepy during the day. You will start thinking and concentrating better. Your chances of falling asleep while driving will decrease significantly.

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Copyright © 2002 by the American Academy of Family Physicians.

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