Snoring

Snoring is noisy breathing during sleep that occurs when relaxed structures in the throat vibrate and make noise. Most snoring is harmless, though it can be a nuisance that interferes with the sleep of others. Some snoring can be stopped with lifestyle changes, particularly losing weight, cutting down on smoking and alcohol, and changing sleeping positions. This generally means keeping snorers off their backs and on their sides as a way to keep the airway more open during sleep. There are over-the-counter nasal strips that are placed over the nose to widen the space in the nose and make breathing easier. Read labels carefully because these strips are only intended to treat snoring. The labels point out certain symptoms that require a doctor's care.

The trick is figuring out the cause of snoring. It could be related to allergies or structural abnormalities such as nasal polyps or enlarged adenoids, which are lymphoid tissue behind the nose.

If your snoring is loud and frequent and you also have excessive daytime sleepiness, you could have sleep apnea. People with sleep apnea tend to also be overweight, and it's more common among men than women.

When a person with sleep apnea tries to breathe in air, it creates suction that collapses the windpipe and blocks the flow of air. Blood oxygen levels fall and the brain awakens the person, who then snorts or gasps for air and then resumes snoring. This cycle is typically repeated many times during the night. It results in frequent awakenings that prevent people from reaching the deepest stages of sleep, which leaves them sleepy during the day.

"In this case, snoring is not just noisy, but could be a silent killer," says Jeffrey Hausfeld, M.D., the author of a book titled Don't Snore Anymore and an associate professor of surgery in the department of otolaryngology at George Washington University School of Medicine and Health Sciences in Washington, D.C. "Sleep apnea has been linked to heart disease, high blood pressure, and stroke," says Hausfeld, whose father suffered from sleep apnea and died of a stroke at age 66.

Hausfeld says that recognizing the signs of sleep apnea in children is a challenge because unlike adults, kids push through daytime sleepiness and keep going. "Sometimes you might see the child struggling to get air or moving around a lot in bed," Hausfeld says. "Rather than being noticeably tired, kids with sleep apnea may do poorly in school."

Doctors use an all-night sleep study to make a definitive diagnosis of sleep apnea. During the test, sensors are attached to the head, face, chest, abdomen, and legs. The sensors transmit data on how many times the person being tested wakes up, as well as changes in breathing and in blood oxygen levels.

Medications generally aren't effective for sleep apnea. There are about 20 FDA-approved devices available by prescription for snoring and obstructive sleep apnea, says Susan Runner, D.D.S., branch chief for dental devices in the FDA's Center for Devices and Radiological Health. "These work for some," she says. "The devices pull the tongue or jaw forward to open the airway." There are no similar over-the-counter devices approved by the FDA. Potential side effects include damage to the teeth and jaw joint.

The most common treatment for sleep apnea is continuous positive airway pressure (CPAP) with a device that pushes air through the airway at sufficient pressure to keep the airway open while sleeping. Radzikowski says using CPAP makes her feel rested during the day. It involves wearing a mask over the nose while sleeping. A blower attached to the mask pushes air through her nasal passages.

Surgery also is an option to treat snoring and sleep apnea. This may include removal of the tonsils or adenoids. To treat snoring, a laser-assisted procedure called uvulopalatoplasty is used to enlarge the airway by reshaping the palate and the uvula, making them less likely to vibrate. For sleep apnea, a laser procedure called uvulopalatopharyngoplasty is used to remove excessive tissue at the back of the throat.

If you're troubled by sleep problems, ask your health-care provider about how your problem should be evaluated and which treatments may be appropriate for you. Experts say it's important to know that you don't have to suffer through sleep problems. Radzikowski says she had never heard of sleep apnea before the car accident that killed her husband.

"I was overweight and I knew I snored loudly. But snoring was like a big joke in our family," she says. "I didn't really take it seriously, and I wish I did."

Michelle Meadows is a staff writer for FDA Consumer.