Snoring occurs when the soft tissue structures of the upper airway collapse during sleep. This partial collapse can occur during any stage of sleep.  When the throat tissues vibrate against each other, it produces the sound known as snoring.  The sound is a sign that the airway is partially blocked. It can come through the nose, mouth, or both the nose and mouth.  Usually, the narrower the airway space, the louder the snoring sounds. A narrow airway can be caused by a large tongue or tonsils or excess fat in the throat.

Signs of Snoring
Some people snore louder than others. Quiet snoring may not disrupt one’s overall quality of sleep. But loud snoring can wake the snorer or disturb a bed partner’s sleep.  Snoring may also cause dry mouth or an irritated throat upon waking up.

Who Snores?
Snoring can affect almost anyone.  Habitual snoring has been found in an estimated 24 percent of adult women and 40 percent of adult men. Both men and women are more likely to snore as they age. Men, however, become less likely to snore after the age of 70.
Snoring is more common in people who are overweight. There is a greater amount of fat in the back of the throat that vibrates during sleep. This excess weight can press down on the airway.

Pregnancy can also increase a woman’s chance of snoring. It can even affect children. An estimated 10 to 12 percent of children snore.
Snoring appears to run in families, but there are some ways to reduce one’s likelihood of snoring. Alcohol, drugs, muscle relaxers and tobacco products can all contribute to snoring. So avoiding these triggers can decrease the problem.

Is Snoring a Cause for Concern?
Snoring itself does not endanger one’s health. But snoring can be a sign of a more serious condition called obstructive sleep apnea (OSA).
About 50 percent of people who snore loudly have sleep apnea. OSA happens when the tissue in the upper-airway blocks the entire airway, causing a pause in a person’s breathing. This blockage keeps air from getting into the lungs, lowering a person’s blood-oxygen levels. This pause in breath can happen for 10 to 30 seconds, sometimes for one minute or more, hundreds of times a night.  Snorers who suffer from OSA often snore loudly and frequently. They may make gasping, choking or snorting sounds as they try to breathe and feel drained of energy during the day.

Patients can undergo a sleep study, or polysomnogram, to determine if their snoring indicates OSA. This test charts a person’s brain waves, heart beat, and breathing as they sleep. It also records a person’s arm and leg movements. People who experience loud snoring and excessive daytime sleepiness should visit a sleep center accredited by the American Academy of Sleep Medicine (AASM). Dr. Forsmark recommends Northern Michigan Regional Hospital Sleep Center located in Petoskey. Phone (231) 487-5337.

Treating Snoring : 4 Different Approaches
Snoring without OSA can be treated in several ways. Medical factors may affect treatment, so it is important to speak with a physician.  

 1.)  Behavioral Therapy
Because excess weight can cause or worsen snoring, weight loss can decrease the severity of snoring or apnea. Weight loss alone may help some, but not all people with snoring.
Avoiding alcohol, drugs, muscle relaxers and tobacco products can also help reduce or eliminate the presence of snoring.

2.)  Positional Therapy
Positional therapy involves side-sleeping instead of sleeping on one’s back. This shift keeps the weight of a person’s neck from collapsing on his or her airway. It may help some, but not all people with snoring.

3.)  Oral Appliance Therapy
Oral appliances are worn in the mouth to treat snoring and OSA. These devices are similar to sports mouth guards but are fitted by dentists trained in dental sleep medicine.  Oral appliance therapy (OAT) involves the selection, design, fitting and follow-up care of a custom-made oral appliance that is worn during sleep. This appliance maintains an opened, unobstructed airway by repositioning the lower jaw and tongue forward. It also stabilizes the lower jaw and tongue, increasing the tongue’s muscle tone.

Many appliances have been FDA-approved for the treatment of snoring and/or sleep apnea. Dentists trained in this therapy are familiar with the various designs of appliances. They know which appliance will work best for each patient’s specific needs. They can also adjust the appliances to avoid side effects, such as jaw or teeth pain.

Dr. Forsmark works with physicians and sleep specialists as part of a medical team in each patient’s diagnosis, treatment, and on-going care.

4.)  Surgical Procedures
Dentists who are oral and maxillofacial surgeons may use a variety of methods to treat upper airway obstruction. These specialists can treat snoring using minimally invasive procedures as well as more complex surgery. Additionally, an Ear Nose and Throat specialist may remove any excess tissue in the throat. It may be necessary to remove tonsils and adenoids (especially in children), the uvula, or even parts of the soft palate and the throat.

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