Causes Of Snoring
Deformities of the nose (deviated septum) – This physical abnormality can cause an obstruction that leads to or worsens snoring.
Bulky tissue in the throat – Large tonsils and adenoids can cause snoring and restless nights. The same can be true for overweight people who have excess soft tissue that can narrow the airway. Cysts or tumors are also possible causes of snoring, but this is a rare situation.
Long soft palate and/or uvula – The excessive length of the soft palate and/or uvula creates noise during relaxed breathing.
Stuffy nose – A stuffy or blocked nose creates an exaggerated vacuum in the throat that pulls together the floppy tissues of the throat, which leads to snoring. In cases like this, snoring may only occur during allergy season or with a cold or sinus infection.
Poor muscle tone in the tongue and throat – Muscles that are too relaxed allow the tongue to fall backward into the airway and/or allow the throat muscles to draw from the sides into the airway. Lack of muscle control can be increased by the use of drugs that cause drowsiness, including alcohol.
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is a serious medical condition in which a person actually stops breathing multiple times while sleeping. These episodes can last over 10 seconds each and can occur 10 to 130 times per hour. OSA causes the heart to work harder and reduces the amount of oxygen in the blood. Most noticeably, it disrupts the sleep cycle and leads to a feeling of sleepiness throughout the day. Untreated obstructive sleep apnea also increases the risk of heart attack, stroke and diabetes in adults.
Signs Of Obstructive Sleep Apnea
Anyone can develop obstructive sleep apnea, although in adults it most commonly affects middle-aged and older adults and people who are overweight. For most adult patients and some children, a sleep study may be needed to diagnose obstructive sleep apnea. Adults or children with any of the following symptoms should definitely be evaluated for sleep apnea:
- Constant snoring in any sleeping position
- Ongoing daytime fatigue or sleepiness
- Episodes of breathing pauses during sleep
Treatment Options For Adults With Sleep Apnea
For adults, the standard treatment recommended for obstructive sleep apnea is some form of PAP (positive airway pressure) therapy. This treatment process consists of wearing a device with a mask that fits either in or over the nose or around the nose and mouth, depending on the type of mask that is fitted. Continuous PAP or CPAP is the most common form of such treatment, and these devices have become more sophisticated and can auto-adjust the pressure for maximum comfort and effectiveness. The CPAP device delivers a steady stream of air to the throat that keeps the throat muscles from collapsing and obstructing the airway during sleep.
For some adult patients, nasal obstruction caused by a deviated septum or enlarged turbinates should be surgically corrected before CPAP treatment can be maximally effective. After removal of the nasal obstruction, these patients typically have much greater success with CPAP treatment.
For adult patients who cannot tolerate CPAP, surgical intervention may be necessary to treat sleep apnea. These procedures may include removal of the tonsils and adenoids or portions of the soft palate and uvula. An ablation procedure to reduce the amount of tissue on the base of the tongue may also be recommended. Tracheotomy and major repositioning of the bones of the upper and lower jaw have been necessary in the most severe cases.
Sleep Apnea In Children
If left untreated, obstructive sleep apnea in children can have negative medical and social effects. Sleep apnea can contribute to moody and disruptive behavior, attention deficit disorder, bedwetting, stunted growth, obesity and cardiovascular issues.
Enlarged tonsils and adenoids are the most common cause of obstructive sleep apnea in children. Obesity can also be a contributing factor for obstructive sleep apnea in children as well as in adults.
For the pediatric patients who have enlarged tonsils and adenoids, adenotonsillectomy, the surgical removal of the adenoids and tonsils, is usually the preferred course of treatment for sleep apnea. When a child is not overweight, removing enlarged tonsils and adenoid tissue will usually resolve obstructive sleep apnea. There are over 500,000 pediatric tonsil and adenoid surgeries in the U.S. each year. The majority of these procedures were performed to successfully treat sleep apnea. With the development of new technologies such as coblation, these procedures are now performed safely as outpatient surgery in most cases, with fewer complications and less discomfort than traditional adenotonsillectomy.
Learn more about pediatric obstructive sleep apnea by reading Obstructive Sleep Apnea in Children – Recognition and Treatment