What Does Snoring Really Mean?
What Does Snoring Really Mean?
By Coral Tieu, MD
That raucous sound emanating from your bedroom at night isn’t just annoying - it’s bad for your health. Snoring is an indicator of inadequate airflow. It can even be accompanied by pauses in breathing, or sleep apnea. For most people who snore, the effect is a double whammy: poor sleep and insufficient oxygenation.
Being able to breathe through your nose is incredibly important. If you find yourself breathing predominantly through your mouth, you’re missing out on a key molecule your body uses to maintain health: nitric oxide. Nitric oxide plays a critical role in managing blood pressure, cardiovascular health and mental acuity. Nitric oxide is a highly unstable molecule that is only active in its gaseous state. This means that in order to be effective, you need a continuous source (like breathing). But mouth breathing won’t work since the majority of nitric oxide is made in the sinuses. Breathing through the nose has been shown to improve mental performance, anxiety and sleep quality. It’s important to be able to keep your mouth closed not just during the day (when it can get you into trouble), but at night as well.
If your mouth won’t stay closed while you’re sleeping, it can be difficult to know how to fix the problem. Where do you even begin?
The answer is tricky because there are actually multiple factors that can create snoring. That irritating rumble can be caused by a blocked nose, a tongue that falls back, sinus issues, allergies, a high palate, certain orthodontic practices, particular pacifiers used as a baby, and weak mouth muscles. In children, prolonged snoring should always warrant a specialist evaluation. In adults, if you find breathing through your nose difficult, a visit to your local Ear, Nose and Throat doctor would also be a good place to start. You’d be surprised how many different offenders can block a person’s nose: septal deviations, polyps, infections, growths, dryness and more! Visualization with a camera is often needed to diagnose what’s blocking airflow.
If you can breathe through your nose most of the time during the day, the cause of your snoring may be weak mouth muscles. If muscles are weak, when the body relaxes during sleep, the mouth will open and the jaw and tongue will fall back, blocking the airway. There are specific exercises, called myofunctional therapy, that have been shown to significantly improve sleep apnea and snoring. As an added bonus, these exercises can improve your jawline and neck tone. Daily activities typically neglect the tongue, lips and cheeks, so intentionally exercising these muscles can make a dramatic impact on resting tone and sleep.
What if your snoring is seasonal or worsens with exposure to certain inhalants like dust or dirt? You may benefit from rinsing your sinuses with salt water. Just like the filter in your air conditioner, your nose needs to be cleaned out in order to function properly. Frequency is highly variable - anywhere from twice daily to a few times a year as needed (such as after riding horses or working in the garden). If you have other symptoms such as watery eyes or sneezing, a trip to the allergist may be helpful to achieve better
control of your symptoms.
What about nasal sprays? It’s important to know what medication you’re using, as they are definitely not all the same. Some medications, like Flonase or Nasacort, are safe to use daily, as long as you have no increased pressure in your eyes such as in glaucoma. In fact, these medications are intended to be used twice daily and don’t reach full effectiveness for 6-8 weeks. These are nasal steroids and they work topically without causing unwanted side effects like oral steroids. Keep in mind, however, that these sprays can cause nosebleeds, so if that happens, stop the Flonase. Unlike steroid sprays, decongestants are not for daily use and should not be used for more than 3 days per month. This category includes Afrin or oxymetazoline. If you use these decongestants more than 3 days a month, your nasal congestion will actually worsen and you become dependent on the spray.
Very often, patients are convinced they need nasal surgery when they really only need to stop using decongestant spray. Although the initial period after stopping can be uncomfortable, the nose will open up after a few days and breathing will dramatically improve. In general, it’s better to stick to nasal steroid sprays for daily control of congestion.
For those with children or grandchildren, prevention is critical. Choosing the wrong pacifier can deform a baby’s palate and create a smaller, crowded nose and mouth. Avoid cylindrical pacifiers (the ones given out in most hospitals). These have been shown in multiple studies to create a lifetime of breathing problems. A much better choice is a wide, flat pacifier, which more appropriately distributes pressure during sucking and protects the soft bones of a baby’s face. The other key element in prevention is avoiding common “restrictive” orthodontic practices, such as pulling healthy teeth. Airway orthodontists are now moving toward palate expansion to solve dental crowding and create more space in a child’s nose and mouth.
Wherever you happen to land in the snoring cycle, there are many options for improvement. It’s important to recognize snoring as a symptom of a larger health issue. Knowing the causes of snoring arms you with options for improving your quality of life and maybe even preventing your loved ones from developing snoring to begin with.
Look for Dr. Tieu’s new book, Breathe Happy – available here: https://www.amazon.com/Breathe-Happy-Optimize-Sleep-Health/dp/B0GW4H848K/