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Why you snore, when to be concerned and how to stop

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Chloe Chioy’s college house-share featured a dingy basement, bug-infested attic, tiny bathrooms and, perhaps worst of all, a snoring roommate. The poor chap could have “won in a noise competition against the fire alarm,” says Chioy, 21, a digital marketing coordinator who attended the University of Sheffield in England and now lives in Taipei, Taiwan.

Chioy and her fellow housemates could not ignore the nightly rumble. They bought their friend nasal strips, but those proved uncomfortable, though he agreed to wear them on pre-exam nights, when solid sleep was extra important. They switched their focus to dampening the racket rather than stopping it, and ultimately achieved some solace by soundproofing the snorer’s walls with cheap foam they found on eBay.

Johns Hopkins Medicine estimates that 45 percent of adults snore occasionally, while 25 percent snore regularly. It can be particularly maddening for the people who live with and sleep near snorers: Kent Smith, the founding director of Sleep Dallas and president of the American Sleep and Breathing Academy, says he recently met with a patient who had scheduled an appointment to try to save his marriage. But snoring isn’t necessarily just a nuisance; it can also signal an underlying medical condition. Here’s what to know about why we snore, how dangerous it is and how to treat it.

What causes snoring?

Snoring is a common condition that happens when something blocks the flow of air through your mouth and nose, says David Schwartz, president of the American Academy of Dental Sleep Medicine and a practicing dentist in the Chicago area. As air attempts to push through, it causes the soft tissues to vibrate, leading to the (often quite irritating) sound known as snoring.

In some cases, people snore because they have a nasal obstruction, deviated septum or collapsed nasal valve, Schwartz says. Or, the sound could be caused by the tongue. “Sometimes the tongue will just fall back against the soft palate and the uvula and tonsils, especially in a person who has a very small airway,” he says. “As air is trying to pass through, it creates vibration.”

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Snoring can be a symptom of obstructive sleep apnea (OSA), a condition that affects about 1 in 5 people, says Steven Holfinger, a sleep medicine specialist at Ohio State University’s Wexner Medical Center. This type of apnea occurs when your throat muscles relax as you sleep, blocking your airway. Snoring that’s caused by sleep apnea is often particularly loud, and it might be accompanied by shallow breaths, gasping or general restlessness.

“Snoring is very much associated with sleep apnea. But not everybody with sleep apnea snores — even though the vast majority do — and not everybody who snores has sleep apnea,” Holfinger says. “That’s where it gets tricky,” and why it’s important to visit a sleep specialist to help determine the root cause of the snoring.

Snoring can also be caused by other less-serious conditions, such as nasal polyps, a crooked septum, the shape of your palate or tongue, or a cold or allergies. Being pregnant or overweight or consuming alcohol can also contribute to snoring.

Is snoring unhealthy?

Exactly how dangerous snoring is often depends on the extent to which you’re angering your bed partner, Smith says. But, jokes aside, he adds, it’s best not to consider it a benign condition. Snoring every once in a while — if you have a cold, for example, or drank too much alcohol before bed — is usually harmless. But if you snore every night, he advises making an appointment with a sleep specialist.

Research indicates that about 90 percent of people with sleep apnea are undiagnosed, and the condition can have serious ramifications, including an elevated risk of heart problems. “We see severe patients all the time, and they have no clue they have sleep apnea,” Smith says. “They’re only coming in because their bed partner told them to.”

Even if you don’t have OSA, snoring could pose a risk to your health. Some research suggests that it’s associated with cardio-metabolic risk factors such as atherosclerosis (disease of the arteries) and endothelial dysfunction (a type of nonobstructive coronary artery disease). A study published in the journal Laryngoscope​, for example, examined people who snored but didn’t have sleep apnea. Researchers found that the longer people spent snoring each night, the more narrowing they had in their neck arteries, which could heighten the risk of stroke.

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If you see a sleep specialist, you’ll probably undergo a sleep study, during which your brain levels, oxygen level, heart rate, and eye and leg movements will be recorded. Such studies “used to be a lot more onerous,” Smith says, and required spending the night at a medical center. But now, at-home studies are becoming the norm. “It’s a more realistic look at [patients’] night-to-night sleep habits,” he says. “It’s their own bed, their own temperature, their own dogs, their own bed partner.”

If a sleep study reveals OSA, patients are typically treated with breathing devices such as a continuous positive airway pressure machine, which blasts a steady stream of air into the nose and mouth during sleep.

What habits can I change to stop snoring?

If your snoring isn’t caused by sleep apnea, there are lifestyle changes you can try, including:

Lose weight. The more you weigh, the more likely it is that you’ll snore. That’s because we carry those extra pounds all over, including in our tongue, which crowds the airway. “So, weight loss will improve your snoring,” Holfinger says. In one study, men who lost more than six pounds greatly reduced their level of nightly snoring, while those who shed about 16 pounds virtually eliminated their snoring.

Quit smoking. “Smoking creates what we call a sticky airway,” Smith says, which means air doesn’t flow in an optimal manner, thus leading to snoring. If you’re a smoker, it’s worth trying to kick the habit (for numerous reasons).

Don’t drink before bed. Alcohol causes the muscles near your airway to relax, increasing the odds that you’ll snore, Holfinger says. It’s best to stop drinking at least a few hours before you go to bed.

Adjust your sleeping position. When you sleep on your back, the tissues in your upper airways might droop, and “you have a much greater chance of snoring,” Schwartz says. If snoring is disrupting your life, try sleeping on your side or using a few pillows to prop up your head. It might make a difference. If it doesn’t help, he says, see a doctor.

What about snoring aids?

There’s a certain aisle at CVS, Walgreens and other large drugstores that’s like a snoring-remedy bonanza. There are chewable tablets and face cushions. There are sleep headbands and anti-snore pillows and chin straps.

“Most of those are pretty gimmicky,” Smith says. Some products might help light snorers, he adds, but it’s best to see a doctor instead of potentially wasting money on items that don’t work. Here are some remedies doctors do recommend:

Nasal strips or dilators. One potentially helpful product you can find in the drugstore is a box of these items. You apply the strips, such as Breathe Right, to the outside of your nose at bedtime; the idea is that they help open your nasal passages, thus reducing snoring. One older study of that brand found that dilators effectively reduce the intensity of snoring in a majority of people, especially if the snorer doesn’t have a condition such as OSA that affects their breathing while they sleep.

Schwartz prefers another over-the-counter product called Mute, which works differently: “It’s really, really small, and it goes into the nostril and opens it up,” so the person’s airflow isn’t limited, he says.

A customized mouthpiece or mouthguard. These appliances pull the jaw and tongue slightly forward, opening the upper airway. You can buy basic versions online, Schwartz says, but those “tend to have a higher association with tooth movement and jaw pain,” and they’re often uncomfortable and/or ill-fitting. “It’s something that really should be made custom to your mouth” by a dentist.

Surgery. There are some outpatient procedures that can help alleviate snoring. For example, laser-assisted uvulopalatoplasty, or LAUP, involves shortening the soft tissue that dangles in the back of the throat, while making small cuts in the soft palate that will later stiffen. Another option, somnoplasty, uses radio waves to shrink the soft tissue that vibrates while you snore.

Surgery is generally “considered a last resort, because it’s painful,” Smith says. And there’s another con: Insurance doesn’t always cover it.

Angela Haupt is a freelance writer and editor. Follow her on Twitter @angelahaupt.

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How to stop ‘revenge bedtime procrastination.’

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