snoring

and Sabine Schrör, medical journalist

Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.

Brief overview

Description: Simple / primary snoring (without breathing pauses) or sleep apnea syndrome (with breathing pauses). In the latter, a distinction is made between obstructive sleep apnea and the less common central sleep apnea.
Causes: Constricted upper airways due to respiratory infections or allergic reactions (simple snoring) or due to anatomical features such as enlarged tonsils (obstructive sleep apnea). Central sleep apnea is caused by a disruption of the central respiratory drive in the brain. Alcohol, medications such as sleeping pills and antihistamines, and sleeping on your back are considered snoring enhancers.
Possible consequences: Sleep apnea (especially obstructive sleep apnea) endangers health and can, for example, lead to high blood pressure, cardiac arrhythmias or heart attacks.
Tips: For simple snoring: lose weight if you are overweight, no alcohol before going to bed, early dinner, do not sleep on your back.
Treatment: Medical treatment options for stubborn snoring: snoring splint, surgical interventions (e.g. tonsil surgery, implants to stiffen the soft palate), nasal breathing apparatus for sleep apnea.

Snoring: description

With simple (primary) snoring, narrowed airways increase the flow speed of the incoming and outgoing air. Together with the muscles of the mouth and throat that are slack during sleep, the uvula and soft palate flutter when you breathe in and out. This creates the snoring noises. The narrowing of the airways during simple snoring is often the result of an infection of the upper respiratory tract (e.g. cold, acute sinus infection) or of allergic reactions. Breathing pauses do not occur with simple snoring.

That happens when you snore

The muscles of the mouth and throat relax during sleep. If the airflow is obstructed by the tongue falling back and the slack palate, the typical fluttering sound is created.

Obstructive sleep apnea syndrome is associated with brief pauses in breathing during sleep. The triggers here are also narrowed upper airways. This narrowing is mostly due to anatomical features in the ear, nose and throat area. These include enlarged tonsils, an enlarged tongue, an enlarged uvula, a lower jaw that is too small, nasal polyps, chronic sinusitis and a crooked nasal septum. The brief pauses in breathing cause the brain to wake up: This is, among other things, associated with an increase in muscle tension, which opens the narrowed airways - the person concerned takes a deep breath, usually accompanied by a loud snoring noise. However, the wake-up reaction usually does not lead to the person concerned waking up properly. Obstructive sleep apnea is most common in overweight men, especially in old age.

With central sleep apnea, snoring noises and breathing pauses during sleep also occur. The brief respiratory arrests are not caused by the closure of the upper airways. Rather, central sleep apnea is based on a disruption of the respiratory drive in the brain: the muscles in the chest and diaphragm are inactive during sleep, so that the person concerned takes too little and not deep enough breath. The resulting lack of oxygen alerts the brain, which immediately initiates the wake-up reaction described above so that the person concerned can breathe again. Central sleep apnea syndrome is usually the result of cardiovascular disease. It mainly occurs in men and in old age. However, central sleep apnea is less common and less dangerous than obstructive sleep apnea.

Snore enhancer

Various factors can make snoring worse. These include, for example:

excessive alcohol consumption
certain medications, such as sleeping pills or antihistamines (drugs used to treat allergies)
Sleeping in the supine position (in this sleeping position the base of the tongue sinks backwards)

Risks from sleep apnea

The nocturnal breathing pauses in sleep apnea (especially obstructive sleep apnea) endanger health. Affected patients have an increased risk of cardiovascular diseases such as high blood pressure, cardiac arrhythmias, heart muscle diseases, heart attacks and strokes. In addition, many suffer from heartburn. In addition, sleep apnea patients cause accidents more often because they are often tired during the day due to the disturbed night sleep and tend to fall asleep (e.g. at the steering wheel).

What helps against snoring?

A wide variety of remedies against snoring are offered, especially on the Internet, such as snoring sprays, snoring pacifiers or snoring lozenges. The effectiveness of none of these products has been proven. In addition, the anti-snoring agents are relatively expensive.

Therefore, you should use other methods to counteract snoring. Sometimes simple measures that you can carry out yourself are sufficient. In persistent cases or in the case of underlying diseases or anatomical peculiarities, the dentist or a specialist in ear, nose and throat diseases (ENT) can help you.

Tips for self-help

You can often do something successfully yourself against simple snoring. Try the following tips against snoring:

If you are overweight, losing weight is the most effective method against snoring. With the kilos, the fat in the throat area, which promotes snoring, also disappears.
Avoid alcohol two hours before bed. Because this reduces breathability and thus promotes snoring.
Eat early for dinner - eating late will reduce the quality of your sleep.
Sedatives, sleeping pills and antihistamines also reduce breathing activity and can provoke snoring. Avoid these when possible.
Don't sleep on your back. A tennis ball sewn into the back of your pajamas can help you with this.
If you don't like sleeping on your side, it is best to lie on your back with your upper body slightly elevated.
Learn a wind instrument to train your throat and palate muscles. The traditional Australian instrument didgeridoo is particularly suitable for this.

Help from the dentist

Some patients benefit from a snoring device. This is a bite splint individually adapted by the dentist for the upper and lower jaw. It keeps the airways open by gently pushing the lower jaw forward. This also causes the tongue and palate to shift. However, the snoring splint is quite expensive and does not always help. It is difficult to predict how effective it will be in individual cases - it is best to try it out.

Operative interventions

Depending on the cause, snoring can sometimes only be eliminated with an operation by the ENT specialist. The most common anti-snoring procedures include:

Tonsil surgery
Sinus surgery
Nasal septum surgery
Turbinate surgery
Soft palate sculptures
Stiffening of the soft palate (implants)
Operations on the base of the tongue
Operations on the hyoid bone

Therapy for sleep apnea

If you suffer from sleep apnea, the oxygen supply must be ensured continuously while you sleep. This is reliably achieved with the help of nasal breathing apparatus that work with positive pressure (nasal continuous positive airway pressure, nCPAP). Air is supplied to the sleeper through a mask. The increased pressure prevents the slack throat from closing during sleep.

A variant of nCPAP is APAP therapy (Automated Continuous Positive Airway Pressure). Here the breathing apparatus continuously adjusts the pressure to the demand. The method makes sense if the breathing pauses only occur in certain sleeping positions or phases.

In particularly severe cases of sleep apnea, BIPAP therapy (Bi Positive Airway Pressure) is an option. The pressure generated during inhalation and exhalation can be set separately.

Snoring: When Should You See a Doctor?

Snoring should generally be examined by a doctor. The best way to do this is to see an ear, nose and throat doctor (ENT doctor) or a clinic that has a snoring center. Especially if you snore loudly and irregularly, you shouldn't wait to see your doctor. There could be a breathing disorder (like obstructive sleep apnea) that can be harmful to your health.

A visit to a doctor is also strongly recommended if you suffer from chronic fatigue, even though you sleep long enough (6 to 8 hours) at night. This could also be a sign of a noxious sleep apnea.

If your child snores, you should also take them to the doctor. Usually enlarged tonsils or tonsils or nasal polyps are the cause of snoring and should be treated.

Snoring: what does the doctor do?

In an initial consultation to collect the medical history (anamnesis), the doctor asks the person concerned and, if possible, their bedfellows for details on the annoying snoring noises. Possible questions are, for example:

How often does snoring occur?
Which factors make snoring worse (e.g. alcohol, nicotine, sinusitis)?
How is snoring (regular / irregular, frequency, volume)?
Do you wake up at night with shortness of breath?
Are you tired during the day?

This is followed by an examination of the nose and throat to determine the cause of the snoring.

To determine whether sleep apnea is present, the doctor will give the patient a snoring test device to take at home. It analyzes breathing during sleep and snoring.

Once the doctor has found the cause of the snoring, he will recommend suitable treatment (e.g. slimming, snoring splint, surgery, etc.).