Why does my husband stop snoring for a breath or two when I nudge him? More importantly, why does he resume snoring after a bit? -- Kimberly Gould, via e-mail
Is there a real way to make snoring stop? I know about the adhesive strips and the sprays, and I spent money today on a book of throat, tongue, and jaw exercises which will supposedly stop my snoring in a matter of weeks. Can such methods work?
Illustration by Slug Signorino
The mechanics behind snoring are straightforward but gross, a reminder that inside each of us resides a tangle of wet, floppy organic structures that ooze around largely as gravity dictates. Much of our breathing equipment consists of soft tissue, and when muscles are relaxed (e.g., during sleep) this tissue may bulge, droop, or otherwise relocate so as to narrow the airway, speeding up the current of air. Snoring occurs when brisk breathing causes the soft palate, uvula, tongue, or other nearby fleshy bits to vibrate, essentially turning your upper respiratory tract into a pretty creepy-looking reed instrument.
Clearly many world-class snorers are born, not made, but aggravating factors abound, including being overweight (extra bulk compresses the tubing), drinking (hurts muscle tone), smoking (never good for respiration), and simply getting older (hence saggier inside and out). Obstructed nasal breathing is central in some cases, negligible in others.
Thus, Kimberly, nudging your husband may unblock his airway just by making him shift slightly, or the muscles in his throat may tense briefly as he edges closer to consciousness. Or if he’s what’s known as a “tongue-base snorer” – i.e., his tongue tends to settle backward into his throat – he may semiconsciously move it out of snoring position (and, if you’re lucky, make that obscene smacking sound familiar to snorers’ bedmates everywhere). But once he settles in again, muscles relax, tissue sags back where it shouldn’t, and the din recommences.
For all its relationship-disrupting potential, snoring might seem somewhat comical as health complaints go if not for its close connection to the scary disorder known as obstructive sleep apnea. Here the sleeper’s airway becomes so blocked by loose tissue that breathing stops entirely for ten seconds or longer; the body wakes up enough to fight noisily for air, then drops back into sleep once breathing resumes. This sequence may recur hundreds of times a night without the sleeper’s knowledge.
Sounds bad, but it gets worse. First, OSA sufferers, unable to obtain deep sleep, are often drowsy all day, making them (for instance) about seven times likelier than average to get into car accidents. Second, OSA is linked to all manner of bad cardiovascular trouble: high blood pressure, heart attack, the works. A 2005 New England Journal of Medicine article reported that having significant OSA doubles your risk of stroke or death, period. It’s not clear why this is, but some researchers suggest that the heart sustains cumulative damage from the massive adrenaline surges released each time the sufferer stops breathing. When I last discussed sleep apnea, two decades ago, the experts were estimating a million cases nationwide. Since then the science has improved and the figure’s gone up a bit – to perhaps 20 million cases, 6 million serious and the vast majority undiagnosed.
Yikes, you say: weren’t we talking about snoring? We still are. OSA sufferers often snore, and maybe half of all loud snorers have OSA. Otolaryngologists at Columbia note that vibrations caused by long-term snoring can actually reshape the soft palate to make airway obstruction more likely; in other words, snoring may not be just an element of OSA but also a recipe for it.
So how to knock it off? Start simply: change sleeping position (i.e., get off your back); drop some weight if that’s an issue. Sprays and oils do nothing, studies indicate. If your snoring is mainly nasal those strips actually might help some, but not if your palate’s the problem.
From here things get invasive. A continuous positive airway pressure (CPAP) device can combat heavy snoring or OSA, but sleeping in a mask that blows air up your nose isn’t for everyone. Then there are surgical procedures: one removes parts of the palate and throat; another shifts the lower jaw forward to enlarge the airway. (A snorer I know rejected the former after learning it would interfere with producing the sound used for R in standard French; he doesn’t speak French, but he hated thinking he’d never be able to pick it up.)
In all, Angela, that book’s probably worth a read. Compare a plan hatched in 2000 by researchers at the University of Exeter, who had 20 habitual snorers take singing lessons and perform vocal exercises for three months. Snoring decreased, but at what cost? No one’s yet surveyed the subjects’ partners, but I’d say the definition of a tough sell is convincing your sleep-deprived spouse you’ll save the marriage by going around singing scales all day.
Send questions to Cecil via firstname.lastname@example.org.