Snoring can be treated

By Nina C. Zimmermann Jul 18, 2011, 3:06 GMT

Berlin - The noises in the bedroom are frightful, night after night after night: wheezing, whistling, snorting, gasping. Snoring can really put a strain on a relationship. While the slumbering partner saws wood, the wakeful one tosses and turns.

Often the latter cannot take the chronic sleep deprivation any longer and urges the former to get to the bottom of his or her snoring, noted Alexander Blau, a physician at the Interdisciplinary Centre for Sleep Medicine at the Charite university hospital in Berlin.

The central question is whether the snoring is merely a nuisance or a sign of a serious health condition. 'Not everyone's who snores is ill,' Blau remarked.

He said the spectrum of snoring, caused by air flowing through relaxed throat tissues that partially obstruct the airway, ranged from completely harmless noise-making, to laboured breathing, to life-threatening sleep apnea, a respiratory disorder 'that can cause problems in waking hours as well as during sleep,' according to the German Sleep Society (DGSM).

'Benign snoring merely causes noise and stress,' said Jan Loehler, a member of the German Association of Otorhinolaryngologists. Being overweight is one possible cause. Excess body fat stored in the neck and throat can constrict the airway during sleep. The simple remedy: weight loss.

Alcohol consumption before bedtime can also cause snoring, Loehler said, because alcohol relaxes throat muscles even more than is usually the case during sleep, thus obstructing the passage of air. The solution is to drink less alcohol or none at all.

The DGSM also recommends a 'stable circadian rhythm with corresponding sleep hygiene' because people who go to bed at irregular times are at a greater risk of snoring.

People with loud, irregular snoring that is punctuated by breaks should by all means see a doctor, advised Blau. Waking up unrested after a night's sleep and feeling exhausted during the day are also warning signs of what Loehler calls 'malignant snoring,' medically known as obstructive sleep apnea (OSA).

This type of snoring can be particularly dangerous for people with a cardiovascular disorder such as cardiac arrhythmia or high blood pressure.

In OSA, throat muscles can become so relaxed during the night that the upper airway repeatedly collapses and breathing stops for as long as 30 seconds. The body's oxygen supply sinks, the amount of carbon dioxide rises and the heart rate slows.

Every time this happens, an alarm goes off in the brain, after which blood pressure, heart rate and muscle tension increase. This results in unusually deep breathing and loud snoring, and the snorer feels exhausted the following morning.

'There are many methods of treatment, but their effectiveness in many cases hasn't been scientifically verified,' Blau noted. One of the two standard treatments, he said, is to wear a mask over the nose at night, which keeps the airway open by means of continuous positive air pressure.

An alternative is a dental mouthpiece that advances the position of the tongue and soft palate to keep the air passage open.

'Theoretically, both the mask and mouthpiece also help in cases of harmless snoring,' Blau said. 'But that would be like using a sledgehammer to crack a nut.'

Snorers should find out whether anatomical abnormalities of the nose and throat are causing them to snore, Loehler said. Enlarged tonsils, a deviated nasal septum (the partition between the nostrils) or an enlarged inferior nasal concha (a bone in the nose) can hinder breathing through the nose.

While surgery can sometimes help, Blau said, much of the available medical literature on the effectiveness of such treatment is not clear-cut. He added, however, that some recent data backs the use of nasal plugs, which also keep the airway open by means of positive air pressure.