Snoring (redirected from snoring disease)

Snoring 

Definition

Snoring is a sound generated during sleep by vibration of loose tissue in the upper airway.

Description

Snoring is one symptom of a group of disorders known as sleep disordered breathing. It occurs when the soft palate, uvula, tongue, tonsils, and/or muscles in the back of the throat rub against each other and generate a vibrating sound during sleep. Twenty percent of all adults are chronic snorers, and 45% of normal adults snore occasionally. As people grow older, their chance of snoring increases. Approximately half of all individuals over 60 snore regularly.

In some cases, snoring is a symptom of a more serious disorder called obstructed sleep apnea (OSA). OSA occurs when part of the airway is closed off (usually at the back of the throat) while a person is trying to inhale during sleep, and breathing stops for more than 10 seconds before resuming again. These breathless episodes can occur as many as several hundred times a night.

People with OSA almost always snore heavily, because the same narrowing of the airway that causes snoring can also cause OSA. Snoring may actually attribute to OSA as well, because the vibration of the throat tissues which occurs in snoring can cause the tissue to swell.

Snoring is associated with physical problems as well as social stress. People who do not suffer from OSA may be diagnosed with socially unacceptable snoring (SUS), which refers to snoring that is loud enough to prevent the sleeper's bed partner or roommate from sleeping. SUS is a factor in the breakup of some marriages and other long-term relationships. Moreover, a study published in 2002 indicates that people who snore are at increased risk of developing type 2 diabetes. Snoring appears to be a risk factor that is independent of body weight or a family history of diabetes.

Causes and symptoms

There are several major causes of snoring, including:

Diagnosis

A patient interview, and possibly an interview with the patient's spouse or anyone else in the household who has witnessed the snoring, is usually enough for a diagnosis of snoring. A medical history that includes questions about alcohol or tranquilizer use; past ear, nose, and throat problems; and the pattern and degree of snoring will be completed, and a physical exam will be performed to determine the cause of the problem. This will typically include examination of the throat to look for narrowing, obstruction, or malformations. If the snoring is suspected to be a symptom of a more serious disorder such as obstructive sleep apnea, the patient will require further testing. This testing is called a polysomnography study, and is conducted during an overnight stay in a specialized sleep laboratory. The polysomnography study include measurements of heart rate, airflow at the mouth and nose, respiratory effort, sleep stage (light sleep, deep sleep, dream sleep, etc.), and oxygen level in the blood.

In some cases the patient may be referred to a dentist or orthodontist for evaluation of the jaw structure and dentition.

In addition, the patient may be examined by sleep endoscopy. In this procedure, the patient is given a medication (midazolam) to induce sleep. His or her throat and nasal passages are then examined with a flexible laryngoscope. In many cases, sleep endoscopy reveals obstructions that are not apparent during a standard physical examination of the throat. Many patients are found to have obstructions at more than one level in their breathing passages.

Treatment

Several surgical procedures are available for treating chronic snoring. These include:

Alternative treatment

There are a number of remedies for snoring, but few are proven clinically effective. Popular treatments include:

Alternative treatments that have been reported to be effective for patients whose snoring is caused by colds or allergies include acupuncture, homeopathy, and aromatherapy treatments. Aromatherapy treatments for snoring typically make use of marjoram oil, which is thought to be particularly effective in clearing the nasal passages.

Prevention

Adults with a history of snoring may be able to prevent snoring episodes with the following measures:

Key terms

Ablation — The removal of abnormal tissue growths by surgery.

Cauterize — To seal tissue or blood vessels using a heat or electrical source.

Continuous positive airway pressure (CPAP) — A ventilation device that blows a gentle stream of air into the nose during sleep to keep the airway open.

Deviated septum — A hole or perforation in the septum, the wall that divides the two nasal cavities.

Endoscope — A slender optical instrument that allows a doctor to examine the inside of the throat or other hollow organ. Sleep endoscopy is a technique that allows the doctor to detect previously unsuspected obstructions in the patient's nose and throat.

Obstructive sleep apnea (OSA) — A potentially life-threatening condition characterized by episodes of breathing cessation during sleep alternating with snoring or disordered breathing. The low levels of oxygen in the blood of patients with OSA may eventually cause heart problems or stroke.

Polysomnography — A technique for diagnosing sleep disorders with the use of a machine that records the pulse, breathing rate and other variables while the patient sleeps.

Soft palate — The structure at the roof of the mouth that separates the mouth and the pharynx.

Resources

Books

Beers, Mark H., MD, and Robert Berkow, MD., editors. "Disorders of the Oral Region." Section 9, Chapter 105 In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.

Beers, Mark H., MD, and Robert Berkow, MD., editors. "Sleep Disorders." Section 14, Chapter 173 In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.

Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part I, Chapter 5, "Acupuncture," and Chapter 8, "Homeopathy." New York: Simon & Schuster, 2002.

Periodicals

Al-Delaimy, W. K., J. E. Manson, W. C. Willett, et al. "Snoring as a Risk Factor for Type II Diabetes Mellitus: A Prospective Study." American Journal of Epidemiology 155 (March 1, 2002): 394-395.

Ayappa, I., and D. M. Rapoport. "The Upper Airway in Sleep: Physiology of the Pharynx." Sleep Medicine Reviews 7 (February 2003): 3-7.

Blumen, M. B., S. Dahan, I. Wagner, et al. "Radiofrequency Versus LAUP for the Treatment of Snoring." Otolaryngology and Head and Neck Surgery 126 (January 2002): 67-73.

Ellis, S. G., N. W. Craik, R. F. Deans, and C. D. Hanning. "Dental Appliances for Snoring and Obstructive Sleep Apnoea: Construction Aspects for General Dental Practitioners." Dental Update 30 (January-February 2003): 16-22, 24-26.

Hassid, S., A. H. Afrapoli, C. Decaesteker, and G. Choufani. "UPPP for Snoring: Long-Term Results and Patient Satisfaction." Acta Otorhinolaryngologica Belgica 56 (2002): 157-162.

Hessel, N. S., and N. de Vries. "Diagnostic Work-Up of Socially Unacceptable Snoring. II. Sleep Endoscopy." European Archives of Otorhinolaryngology 259 (March 2002): 158-161.

Maurer, J. T., B. A. Stuck, G. Hein, et al. "Treatment of Obstructive Sleep Apnea with a New Vest Preventing the Supine Position." [in German] Deutsche medizinische Wochenschrift 128 (January 17, 2003): 71-75.

Nakano, H., T. Ikeda, M. Hayashi, et al. "Effects of Body Position on Snoring in Apneic and Nonapneic Snorers." Sleep 26 (March 15, 2003): 169-172.

Remacle, M., E. Jouzdani, G. Lawson, and J. Jamart. "Laser-Assisted Surgery Addressing Snoring Long-Term Outcome Comparing CO₂ Laser vs. CO₂ Laser Combined with Diode Laser." Acta Otorhinolaryngologica Belgica 56 (2002): 177-182.

Stevenson, J. E. "Diagnosis of Sleep Apnea." Wisconsin Medical Journal 102 (2003): 25-27, 46.

Trotter, M. I., A. R. D'Souza, and D. W. Morgan. "Medium-Term Outcome of Palatal Surgery for Snoring Using the Somnus Unit." Journal of Laryngology and Otology 116 (February 2002): 116-118.

Organizations

American Academy of Otolaryngology, Head and Neck Surgery, Inc. One Prince Street, Alexandria, VA 22314-3357. (703) 836-4444. http://www.entnet.org.

American Academy of Sleep Medicine (AASM). One Westbrook Corporate Center, Suite 920, Westchester, IL 60154. (708) 492-0930. http://www.aasmnet.org.

American Dental Association. 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2500. http://www.ada.org.

American Sleep Apnea Association. Wake-Up Call: The Wellness Letter for Snoring and Apnea. 1424 K Street NW, Suite 302, Washington, DC 20005. (202) 293-3650. http://www.sleepapnea.org.

National Sleep Foundation. 1522 K Street, NW, Suite 500, Washington, DC 20005. http://www.sleepfoundation.org.

Other

American Sleep Apnea Association (ASAA). Considering Surgery for Snoring? 〈http://www.sleepapnea.org/snoring.html〉.

National Heart, Lung, and Blood Institute (NHLBI). Facts About Sleep Apnea. NIH Publication No. 95-3798. [cited April 13, 2003]. 〈http://www.nhlbi.nih.gov/health/public/sleep/sleepapn.htm〉.

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snoring

an involuntary, deep guttural sound emanating from the pharynx and soft palate on inspiration or expiration; often intermittent depending on posture of the head. May indicate a chronic, obstructive lesion of pharynx.

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snoring disease

is an enzootic rhinitis of cattle caused by Helminthosporium spp.