February 17, 2006
Friday

A snore can rip through the quiet of night like a thunderclap on a cloudless day.

Snoring disrupts sleep and fractures relationships. It causes resentment and hurt feelings. It can drive couples apart, both physically and emotionally.

According to a poll conducted by the National Sleep Foundation in 2005, 59 percent of adults between the ages of 18 and 65 reported that they snore. More than half of those who reported snoring said that their snoring bothered others. And 7 percent said that their snoring was loud enough to be heard in adjacent rooms.

There's snoring, and there's "heroic" snoring, noise that can be heard more than two bedrooms away, according to the University of California, Irvine. Heroic snoring can disturb entire households.

Both men and women snore. But men are at least twice as likely as women to snore, said Dr. Brandon Chandos. Chandos is a neurologist and the director of neurophysiology at North Carolina's Forsyth Medical Center. "The reason is probably anatomical," he said. "Men have fatter necks, which constricts the airway."

What makes people snore? "The sound is produced by vibration of the soft tissue in the back of the throat as air tries to pass through a constricted airway," Chandos said. "Anything that affects the flow of air can cause snoring." Culprits can be sinus congestion, enlarged tonsils or adenoids or a long soft palate. Other risk factors for snoring include being overweight and/or over the age of 40, having a neck size greater than 17 inches and having a family history of snoring. Drinking too much and taking muscle relaxants can also cause a person to snore.

Snoring usually has consequences for those who sleep with or near the snorer. They are the ones who can't fall asleep because of the noise or wake up when the snoring starts. But some people snore because they suffer from sleep apnea, a condition that causes them to stop breathing, sometimes as often as 300 times a night. Breathing can stop for a few seconds or for as long as a minute. The breathing pauses disturb sleep, and sleep apnea's sufferers often feel drowsy during the day. They sometimes suffer from mood changes and have trouble concentrating. Sleep apnea can be associated with heart disease, diabetes and stroke.

Solutions to snoring vary, according to its causes.

"The first treatment is usually the spouse hitting the individual with their elbow and saying, 'Turn over,'" Chandos said. "The second treatment is learning to sleep in a position that decreases snoring, usually sleeping on the side. When you sleep on your back, the tongue and palate are more likely to fall against the back of the throat, narrowing that airway."

Some people with minor snoring problems find relief from over-the-counter remedies, such as nasal sprays or breathing strips that help open the nasal passages and allow air to pass more easily.

Sometimes weight loss can effectively end snoring. Dental appliances that change the way sleepers hold their jaws when they sleep can work.

Surgery may be needed to solve some peoples' snoring, said Dr. Whit Mims, an otolaryngologist One solution is to insert small pieces of woven polyester, called pillars, in the soft palate to stiffen it. That method has a success rate of about 70 percent. Another method is to zap the soft palate with radio-frequency waves in order to shrink the tissues, which will make them less likely to vibrate, Mims said. The procedure, with a success rate of 60 percent to 70 percent, often has to be repeated. Both procedures cost between $1,500 to $3,000, Mims said, and are usually not covered by health insurance.

Other surgeries might include a tonsillectomy or repair of a deviated septum, Chandos said.

Surgical treatment of snoring is more likely to be successful in relatively young patients who are not overweight, he said.

Snorers with sleep apnea and those whose snoring isn't relieved by surgery can benefit from continuous positive airway pressure, or CPAP, treatment, which requires the sleeper to wear a nasal mask that provides a constant level of air pressure.

"It kind of pushes the air in," Mims said. "The pressure keeps tissues open that would otherwise tend to close." Some people have trouble learning to sleep while wearing the mask, he said, but those who do usually find they sleep much better.

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