Alicia Jacobs, MD, family medicine physician, is Vice Chair of Clinical Operations in Family Medicine at The University of Vermont Medical Center. She is also practices at Family Medicine Colchester.

Is snoring normal?

Snoring is certainly common. In the over 65 age group, about 45% of men and 30% of women snore. Though not necessarily normal it can be benign (not risky to your health). More and more people are snoring now that our average body weights are increasing. Snoring is caused by obstruction of tissues during inspiration, or breathing in. It can be related to weight (increases in layers of fat narrow the upper airway), allergies (inflammation of the nose and throat can also narrow the airway), heavy alcohol intake (which relaxes the airway too much), and smoking.

How much snoring is too much?
Primary snoring is not dangerous for your health – it mostly affects the bed partner of the snorer by interrupting their sleep.  Some people, however, develop snoring associated with Obstructive Sleep Apnea. This condition it quite dangerous, as it can contribute to heart disease, stroke and high blood pressure.

How do I know if I have Sleep Apnea?
If snoring is associated with severe daytime drowsiness, multiple nighttime awakenings or actual pauses in your sleep, you may have obstructive sleep apnea (OSA). In OSA, the snoring occurs instead on exhalation or breathing out. The airway collapses and stops the flow of air coming out of the lungs, causing a break or pause in breathing called an apneic episode. OSA is diagnosed with a sleep study that measures depth of sleep, awakenings, pauses in breathing and level of oxygen in the blood.

How serious is Sleep Apnea?
The pauses in breathing that occur in OSA increase the pressure in the chest, making the heart work harder. Eventually, over time, this can lead to a type of heart failure (right-sided) which is very difficult to treat and can be fatal. People with Sleep Apnea snoring can also have difficult to treat hypertension.

How can I make snoring better?
Try a wedge foam mattress to get off your back. Alternatively, you can make a snug T-shirt with a pocket or sock sewn into the back along the spine, which is then stuffed with several tennis balls to accomplish the same thing. Treat any nasal allergies. Try over-the-counter treatments (like nasal strips). Quit smoking and drink less than 1-2 drinks of alcohol per day (possibly none). Best of all, try to lose weight to get your BMI (Body Mass Index) to less than 30. Your doctor can calculate an ideal weight for you.

Is Sleep Apnea treated differently?
Typically OSA will respond to weight loss. Otherwise it is often treated very differently than primary snoring. Usual treatment is with a breathing machine called C-PAP or Bi-PAP that pushes air into the airways and keeps them open while sleeping to eliminate the collapses that causes the apneic episodes. Some people will respond to an oral mouth splint or even surgery to remove tonsils and other structures in the soft palate at the back of the mouth.

If you are struggling with symptoms, or have any of the symptoms of Obstructive Sleep Apnea, please make an appointment with your primary care doctor for further evaluation and possible treatment.

Alicia Jacobs, MD, family medicine physician, is Vice Chair of Clinical Operations in Family Medicine at The University of Vermont Medical Center. She is also practices at Family Medicine Colchester.

 

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