Is snoring hurting your health?
What causes snoring, how to fix it and when it might be something more.
Best Health Magazine, November/December 2016
My husband’s snoring has been known to startle him out of a deep sleep on nights when he has imbibed a few too many bevvies with his buddies. More often, the sound’s bed-shaking vibration rouses me and I nudge him, ever so gently (OK, sometimes it’s an angry shove), so he rolls onto his side and resumes a blessedly silent intake of breath.
We avoid the noisy sleep disturbance by planning ahead: I tell him to sleep in the basement if he’s going to stay out late. And in case he forgets, I double down on my chances of a good night’s sleep by jamming in orange earplugs.
Sexy, it ain’t. But snoring is a fact of life for us, like it is for more than one-third of Canadian couples, so we do what we can to minimize its impact on those precious hours of slumber. The Canadian Sleep Review 2016, which polled adults across the country on their sleep habits, including snoring, found that 67 percent of Canadians also wish they could get better-quality sleep most nights. Silencing the log sawing would help.
Getting A Quiet Night’s Sleep
“Snoring is an extremely common problem,” says Brian Rotenberg, an associate professor in the department of otolaryngology and director of the Sleep Surgery Program at Western University. “About half of adult men and about one-third of adult women snore at night, and snoring ranges in severity from just a little rumble to this freight train coming down the tracks.” But even gentle snoring can disrupt sleep and lead to chronic sleep deprivation for both the snorer and his or her significant other. In fact, the bed partner of someone with sleep apnea can lose up to one hour of sleep each night from awakening to the sound of snoring, a side effect of apnea known as spousal arousal syndrome.
Snoring can also lead to marital problems that stem from couples sleeping apart and experiencing less intimacy as a result. Pop culture has long played up snoring as a kind of running gag that tests a couple’s commitment (who can forget Meredith Grey’s adorable nighttime snuffling that drove McDreamy crazy on Grey’s Anatomy?), but it’s not as cute and harmless in real life.
When Snoring Damages Your Relationship…
“Snoring can lead to significant disruptions in relationships and intimacy, so it’s a concern, especially when it’s disrupting a partner’s sleep,” says Anu Tandon, an assistant professor in the department of respiratory and sleep medicine at Sunnybrook Health Sciences Centre in Toronto. What’s more, snoring can be a symptom of a very serious health problem called obstructive sleep apnea (OSA), which is when the airway closes during sleep and breathing stops for several seconds or even minutes before starting again (a stoppage of breathing for a minimum of 10 seconds is considered abnormal). People with OSA are at higher risk of having a heart attack because of the stress placed on the heart from lower oxygen levels and the stoppage in breathing.
OSA sufferers also have a greater risk of developing hypertension because poor oxygenation causes the body to release the stress hormone epinephrine, which shrinks blood vessels. Doctors are also starting to look at non-apnea snoring as a health problem. There’s emerging evidence that vibrations from snoring can be a cause of carotid artery blockage in the neck.
“It’s causing micro-trauma in the arteries,” says Rotenberg. “It’s shaking them so much that they get cracks in them and then they get scarred all over, so sleep apnea in itself can be a risk factor for heart attack and stroke. When you think about what is happening physiologically, it’s downright scary.”
What Causes Snoring?
When we sleep, our muscles relax and this happens in the throat, too, which narrows and becomes floppy. When snorers breathe in, their uvulas and the walls of their throats begin to vibrate, which is what makes that snoring noise – the narrower the throat, the louder the snore.
The reason more men snore than women comes down to physiology. More men are overweight or obese, which is the top cause of snoring because extra weight exerts more pressure on the upper airway. Men also usually have larger necks than women, and that girth weighs down on their throats during sleep. They also tend to have longer palates and larger noses; together, the long palate deepens the sound of snoring, and the nose amplifies it. So, yes, men are also louder snorers than women.
But women shouldn’t gloat about their good fortune just yet – we’re still the ones who are more likely to wake up from the nightly nuisance. And as we move into menopause, our likelihood of developing snoring increases.
“Pre-menopause, it has been shown that the hormones estrogen and progesterone can actually protect your airway,” says Tandon. “It changes after menopause, so men will still have more sleep apnea and snore more than women, but the gap lessens.”
What Makes Snoring Worse?
It’s not my imagination: Those extra alcoholic beverages actually do aggravate my husband’s snoring. In fact, depressants – from scotch to sleep aids like Advil PM to prescription pills – promote snoring because they further relax muscles in the upper airway.
Back sleeping can also worsen nocturnal snorts because that position causes the tongue and palate to fall back, blocking the airway. Some people find relief by taping a tennis ball to their backs to prevent them from rolling onto them while they sleep. But Rotenberg notes that true snorers – and those with sleep apnea – will snore no matter what their position.
Finally, weight gain can turn a quiet sleeper into a bonafide snorer over time. This is why doctors routinely suggest weight loss for overweight snorers as a lifestyle change that can improve or even eliminate snoring.
In fact, lifestyle modifications, such as shedding pounds, drinking less alcohol, eliminating sedatives and side sleeping, are the first remedies to try to combat snoring. “There are those things that most anybody can do, and they’re helpful,” says Rotenberg. “Are they going to fix everything? Probably not, but they can improve quality of life and possibly lessen snoring.”
When Is Snoring A Health Problem?
Between 20 and 25 percent of snorers may have a degree of sleep apnea, a condition in which breathing stops during sleep. Typically, someone with obstructive sleep apnea will present with more symptoms than just snoring, says Tandon. The hallmark signs of OSA are choking or gasping during sleep – often noted by the bed partner – and regular snoring that suddenly stops and is followed by a gasp or sharp intake of breath moments later. Other signs include morning headaches and constant daytime fatigue.
“Sleep apnea should be investigated and treated because of its associated health risks,” says Rotenberg. “For snorers who don’t have sleep apnea, it becomes an elective situation. What do you want to have done?”
The first stop is the family physician, who will order that a sleep study be conducted at a sleep clinic or at home. A sleep study screens for sleep apnea by tracking sleep, breathing patterns and blood oxygen levels through the night. If sleep apnea is present, expect a referral to a respirologist or surgeon for treatment.
What Are The Treatment Options?
If snoring is caused by OSA, treatments may include lifestyle modifications like weight loss, in combination with therapies like a custom dental appliance, which pulls the jaw forward to open the airway, or continuous positive airway pressure (CPAP), which delivers pressurized air to the throat via a mask and hose to keep the airway open during sleep. A sleep specialist or respirologist may recommend it as a treatment option after sleep apnea has been diagnosed, though it’s poorly tolerated since less than half of people will continue to use the device after it has been prescribed, mentions Rotenberg.
Surgery is an option to treat regular snoring if there is a contributing structural problem, such as large tonsils or a deviated septum, or sleep apnea. Less-invasive treatment options include lifestyle changes such as side sleeping, curbing alcohol consumption and avoiding sleep aids. For the bed partner, earplugs can make a big difference.
Unfortunately, Rotenberg says that drugstore remedies, like nasal strips, aren’t proven. I joke that we should get the Sleep Number bed so that my husband can sleep propped up. Either that or I’m going to tape a tennis ball to his back when he comes home late.