Snoring

Snoring is the sound of turbulent airflow vibrating soft tissue in a partially narrowed upper airway during sleep. Muscle tone falls during sleep, particularly in REM, allowing the soft palate, uvula and tongue base to collapse inward. The clinically important distinction is between simple snoring and obstructive sleep apnea, in which the airway closes repeatedly, producing oxygen desaturation, sympathetic surges and fragmented sleep. Loud snoring punctuated by silences and gasping, witnessed apneas, morning headache, and daytime sleepiness all point toward apnea and warrant a sleep study rather than reassurance, because untreated apnea carries cardiovascular, metabolic and accident risk that simple snoring does not. Anatomical and behavioural contributors are usually identifiable. Weight gain, particularly around the neck, narrows the airway; alcohol and sedatives reduce pharyngeal muscle tone; nasal obstruction from rhinitis or septal deviation increases negative inspiratory pressure and worsens collapse; and supine sleep allows the tongue to fall back. Positional therapy helps a substantial subgroup whose snoring is largely supine-dependent. Weight loss is the most reliable intervention where excess weight is present, and mandibular advancement devices work well for snoring and mild apnea. Supplements have no meaningful role. Products marketed for snoring rely on lubricant or anti-inflammatory claims without controlled evidence, and treating any underlying nasal inflammation is more productive.

• •Loud breathing sounds during sleep
• •Witnessed pauses or gasping
• •Dry mouth or sore throat on waking
• •Morning headache
• •Unrefreshing sleep
• •Daytime sleepiness
• •Partner sleep disruption

• •Excess weight and neck circumference
• •Nasal obstruction
• •Alcohol or sedatives
• •Supine sleep position
• •Enlarged tonsils or adenoids
• •Jaw anatomy
• •Hypothyroidism

Reduced pharyngeal muscle tone during sleep, excess soft tissue and neck circumference from weight gain, nasal obstruction from rhinitis or septal deviation, alcohol and sedative use, supine sleeping position, enlarged tonsils or adenoids particularly in children, retrognathic jaw anatomy, and hypothyroidism.