Skip to main content The Best Websites About Snoring, Sleep Apnea, and CPAP TherapyLong considered little more than a nuisance, snoring is no longer something to ignore -- to the delight of frustrated bed partners everywhere. To sleep physicians, snoring is a sign that something's up. "When you are snoring, you're spending too much energy to breathe," says Dr. M. Safwan Badr, M.D., president of the American Academy of Sleep Medicine. "Snoring is like fever for a general internist -- it tells you somethig is going on, but it doesn't tell you what." Snoring occurs when a person's airways have narrowed, causing the air that passes through it as we breathe to vibrate the soft tissue of the throat. "In principle, snoring is not normal," he says. As a physician, he says he would want to know why that person is snoring in order to provide the best treatment, rather than have a snorer attempt to take her medical care into her own hands. "I would make sure that the body isn't telling us to look for sleep-disordered breathing or sleep apnea," he says.
During sleep apnea, snorers actually stop breathing, sometimes hundreds of times a night. It's important to receive an accurate diagnosis because of sleep apnea's many implications in other health conditions. Sleep apnea raises risk of heart attack, depression and diabetes. But even if snoring is due to a case of seasonal allergies or nasal congestion, there are treatments that can improve those conditions that only a physician would think to suggest, he says. Still, many snorers and their aggravated bed partners are looking for a little at-home relief. Badr walked us through the options on the market that might work -- and what's not worth your time or money. The verdict: Skip 'em. Badr says these usually don't work. A narrowing of nasal passages that's severe enough to cause snoring happens deeper than can be fixed with a sticky strip. "They may or may not affect the acoustics," he says, "but not the mechanics of the airway." In other words, a frustrated bed partner may hear quieter snoring from someone wearing a nasal strip, but "the phenomenon will not go away," he says.
The verdict: Try it! Excess weight can add tissue to the neck that presses and restricts airways, leading to the vibrations that produce snores, says Badr. "Left to their own devices, people who keep adding a few pounds every year may develop sleep apnea, but if they gained the weight and then started snoring, losing the weight may help alleviate the snoring." Not to mention, losing excess weight carries a number of additional health benefits! Sleeping On Your SideBecause there's greater pressure on the throat when you're lying on your back, shifting to your side can really quiet that snore, says Badr. Back-sleeping snorers are probably used to frequent elbowing from their bed partners, he says. To save yourself those bruises, experts recommend a crafty trick: Sew a tennis ball into the front pocket of an old t-shirt, then wear the shirt backwards to bed. Lying on your back will be pretty uncomfortable, so you won't be tempted to drift that way in your slumber! Sleep With A Humidifier
The verdict: Consider it. If your snoring is due to nasal congestion or allergies, and your nasal congestion or allergies are worse in dry air, sleeping with a humidifier might help, says Badr, and it certainly won't hurt. However, he says, "there may be a kernel of truth in a lot of these home remedies, but they're probably not the whole story." Believing you can cure snoring with the switch of a humidifier minimizes the gravity of snoring, rather than encouraging you to bring it to the attention of your physician, he says. Saying No To A NightcapAn occasional snorer may find the problem exacerbated by an adult beverage before bed, says Badr. That's because alcohol relaxes those muscles keeping the airways open. Alcohol before bed also leads to less restful, more disturbed sleep, so it's smart to skip the nightcap even if you don't snore.While it's true that different neck positions can expand or narrow the airways, chances are you're not going to stay put throughout the night, says Badr.
Eliminating snoring is usually not as simple as buying a new pillow, he says, and there hasn't been any scientific evidence to support their use.The FDA has approved nasal valves for the treatment of sleep apnea, says Badr, and they may be available over the counter for snoring as well. However, they're one-time use, and not exactly cheap, he says. The verdict: Consider one if you've exhausted other options. In someone with sleep apnea who either doesn't respond to or doesn't tolerate treatment with a continuous positive airway pressure (CPAP), a type of mouthguard that moves the jaw can be helpful. Badr says these devices may also provide some benefit for people who snore, but without a sleep apnea diagnosis to show your insurance company, expect a hefty price tag. The verdict: Consider it infrequently. "CPAP is the gold standard," says Badr, and if your snoring is so bad you'd consider surgery, you probably do have sleep apnea, he says. Surgery would only be considered in cases where CPAP treatment didn't prove effective, and a team of physicians and specialists would have to perform a comprehensive sleep assessment to come up with the best plan, he says.
Basically, sleep apnea or snoring surgery is not to be taken lightly. Bottom line: Don't ignore your snoring, especially if you have other health conditions or feel tired during the day, Badr says. "People tend to explain away their symptoms, and they could be missing something."Sleep apnea is a serious sleep disorder that occurs when a person's breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night. There are two types of sleep apnea: obstructive and central. Obstructive sleep apnea is the more common of the two. Obstructive sleep apnea occurs as repetitive episodes of complete or partial upper airway blockage during sleep. During an apneic episode, the diaphragm and chest muscles work harder as the pressure increases to open the airway. Breathing usually resumes with a loud gasp or body jerk. These episodes can interfere with sound sleep, reduce the flow of oxygen to vital organs, and cause heart rhythm irregularities.
In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe due to instability in the respiratory control center. Central apnea is named as such because it is related to the function of the central nervous system. Sleep apnea occurs in about 25 percent of men and nearly 10 percent of women. Sleep apnea can affect people of all ages, including babies and children and particularly people over the age of fifty and those who are overweight. Certain physical traits and clinical features are common in patients with obstructive sleep apnea. These include excessive weight, large neck, and structural abnormalities reducing the diameter of the upper airway, such as nasal obstruction, a low-hanging soft palate, enlarged tonsils, or a small jaw with an overbite. These figures illustrate the upper airway in normal sleep (A; person is lying on back, face up) and in obstructive sleep apnea (B). The arrows indicate complete obstruction in the back of the throat.
Obstructive sleep apnea is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses during sleep. Central sleep apnea is usually observed in patients with central nervous system dysfunction, such as following a stroke or in patients with neuromuscular diseases like amyotrophic lateral sclerosis. It is also common in patients with heart failure and other forms of cardiac and pulmonary disease. Often the first signs of OSA are recognized not by the patient, but by the bed partner. Many of those affected have no sleep complaints. The most common signs and symptoms of OSA include: People with central sleep apnea more often report recurrent awakenings or insomnia, although they may also experience a choking or gasping sensation upon awakening. Symptoms in children may not be as obvious and include: If left untreated, sleep apnea can result in a number of health problems including hypertension, stroke, arrhythmias, cardiomyopathy (enlargement of the muscle tissue of the heart), heart failure, diabetes, obesity and heart attacks.
In addition, untreated sleep apnea may be responsible for job impairment, work-related accidents, and motor vehicle crashes as well as academic underachievement in children and adolescents. The diagnosis of sleep apnea is relatively straightforward. If your doctor determines that you have symptoms suggestive of sleep apnea, then your doctor may ask you to have a sleep evaluation with a sleep specialist or may order an overnight sleep study to objectively evaluate for sleep apnea. Testing includes having an overnight sleep study called a polysomnogram (PSG). A PSG is performed in a sleep laboratory under the direct supervision of a trained technologist. During the test, a variety of body functions, such as the electrical activity of the brain, eye movements, muscle activity, heart rate, breathing patterns, air flow, and blood oxygen levels are recorded at night during sleep. In some cases, a Home Sleep Test (HST) may be performed instead. This is a modified type of sleep study that can be done in the comfort of home.
It records fewer body functions than PSG, including airflow, breathing effort, blood oxygen levels and snoring to confirm a diagnosis of moderate to severe obstructive sleep apnea. It is not appropriate to be used as a screening tool for patients without symptoms. It is not used for patients with significant medical problems (such as heart failure, moderate to severe cardiac disease, neuromuscular disease, or moderate to severe pulmonary disease). It is also not used for patients who have other sleep disorders (such as central sleep apnea, restless legs syndrome, insomnia, circadian rhythm disorders, parasomnias, or narcolepsy) in addition to the suspected obstructive sleep apnea. Conservative treatments—In mild cases of obstructive sleep apnea, conservative therapy may be all that is needed. Overweight persons can benefit from losing weight. Even a 10 percent weight loss can reduce the number of apneic events for most patients. However, losing weight can be difficult to do with untreated obstructive sleep apnea due to increased appetite and metabolism changes that can occur with obstructive sleep apnea.
Individuals with obstructive sleep apnea should avoid the use of alcohol and certain sleeping pills, which make the airway more likely to collapse during sleep and prolong the apneic periods. In some patients with mild obstructive sleep apnea, breathing pauses occur only when they sleep on their backs. In such cases, using pillows and other devices that help them sleep in a side position may be helpful. People with sinus problems or nasal congestion should use nasal sprays or breathing strips to reduce snoring and improve airflow for more comfortable nighttime breathing. Avoiding sleep deprivation is important for all patients with sleep disorders. Mechanical therapy—Positive Airway Pressure (PAP) therapy is the preferred initial treatment for most people with obstructive sleep apnea. With PAP therapy, patients wear a mask over their nose and/or mouth. An air blower gently forces air through the nose and/or mouth. The air pressure is adjusted so that it is just enough to prevent the upper airway tissues from collapsing during sleep.
PAP therapy prevents airway closure while in use, but apnea episodes return when PAP is stopped or if it is used improperly. There are several styles, and types of positive airway pressure devices depending on specific needs of patients. Mandibular advancement devices—These are devices for patients with mild to moderate obstructive sleep apnea. Dental appliances or oral mandibular advancement devices that help to prevent the tongue from blocking the throat and/or advance the lower jaw forward can be made. These devices help keep the airway open during sleep. A sleep specialist and dentist (with expertise in oral appliances for this purpose) should jointly determine if this treatment is best for you. Nasal Expiratory Positive Airway Pressure – The device is worn over both nostrils with the mouth closed to cause an increase in the airway caliber by increasing expiratory resistance. Oral Pressure Therapy – The device is worn in the mouth with the patient breathing through the nose.
A vacuum pump with negative pressure pulls the soft palate forward to open the airway. Hypoglossal Nerve Stimulator – A stimulator is implanted under the skin on the right side of the chest with electrodes tunneled under the skin to the hypoglossal nerve in the neck and to intercostal muscles in the chest. When the hypoglossal nerve is stimulated, the tongue moves forward out of the airway and the airway is opened. Surgery—Surgical procedures may help people with obstructive sleep apnea and others who snore but do not have sleep apnea. There are many types of surgical procedures, some of which are performed as outpatient procedures. Surgery is reserved for people who have excessive or malformed tissue obstructing airflow through the nose or throat, such as a deviated nasal septum, markedly enlarged tonsils, or small lower jaw with an overbite that causes the throat to be abnormally narrow. These procedures are typically performed after sleep apnea has failed to respond to conservative measures and a trial of CPAP.