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Snoring is a loud, noisy breathing sound that occurs during sleep. Sufferers may be unaware that they snore and only realise it upon observation by others. Snoring, which is more common in adults, may not always be linked to a health problem. However, snoring causing disrupted, unfulfilling sleep may be a symptom of obstructive sleep apnea (OSA).

Snoring and its causes
The harsh, hoarse sounds of a snore are caused by turbulent airflow when breathing while asleep. When you sleep, the airway at the back of the throat narrows as the muscles relax. This may lead to turbulent airflow that causes the tissues surrounding the palate and mouth to vibrate, hence producing the sound known as a snore. The snoring sound may come from the nose, mouth or both and may occur at any sleep stage.

Conditions that cause narrowing of the airways may lead to snoring. Consuming alcohol before bedtime relaxes throat muscles, thus increasing the risk of airway narrowing. Taking sleeping medications or muscle relaxants may also give the same effect. People with naturally low and thick palates, or who are overweight (i.e. have extra tissues at the back of the throat) have a higher tendency to snore too. So do people with chronic nasal problems (e.g. nasal allergies and congestion) and those with deformities in the nasal structure (i.e. crooked or bent nasal partition). Pregnant women are also more prone to snoring due to a thickened palate.

Snoring and obstructive sleep apnea
In the middle of the night, some snorers may wake up feeling breathless or gasping for air – this may be a symptom of OSA. Other symptoms include excessive sleepiness in the day, waking up not feeling well rested, headaches and difficulty concentrating or remembering things. Weight gain, chest pain at night, moodiness and irritability are also some of the symptoms associated with OSA.

Patients with OSA are at a higher risk of developing cardiovascular diseases such as high blood pressure, heart conditions and stroke. Children with OSA are also at an increased risk of behaviour problems such as aggression or learning problems. Once such symptoms surface, it is important to seek medical advice and get it diagnosed. Diagnosis of OSA may require an imaging test to check airway structure and a sleep study (polysomnography) done either at home or in a sleep centre. The sleep study can give an in-depth analysis of a person’s sleeping habits.

Snoring and its management
Management of snoring may vary depending on the cause. For mild and occasional snorers, behavioural or lifestyle modifications may help to alleviate symptoms. For instance, losing weight and avoiding alcohol before bedtime may reduce snoring. It is important that snorers establish regular sleeping patterns. Chronic nasal problems should be addressed (e.g. using steroid nasal sprays for inflammation or nasal strips to open up nostrils). Sleeping sideways and raising the head of the bed may reduce snoring for those who snore more when lying on their back. Homoeopathic nasal and throat sprays for snoring do not have any studies to back efficacy claims.

For more serious cases, a dental device that holds the tongue in position or slides the jaw forward, preventing airway collapse, may be used. Continuous positive airway pressure (CPAP) is a common device used to reduce snoring and treat OSA. CPAP supplies constant, increased air pressure, preventing airway narrowing during sleeping. Surgical options include palatal implants, traditional surgery to remove excess throat tissues and laser-assisted surgery to shorten the palate. In addition, radio-frequency radio ablation (somnoplasty) can be used to shrink tissues to shorten the palate.

Snoring becomes a problem when it disrupts the snorer’s and their bedmate’s sleep. It is therefore important to monitor the condition, try to manage it through lifestyle modifications and know when to seek medical advice.

For any queries related to sleep apnea, the staff from Gorokan Guardian Pharmacy are here to help.