Snoring may be one of the most common complaints that a spouse reports to their doctor. Snoring can cause what is known as a “sleep divorce” where the spouse becomes so frustrated that the couple separates at night. Getting your spouse to stop snoring may be a matter of changing sleep positions, medications, or even surgery.
Primary snoring is common. Everyone snores at some point in their lifetimes.
Snoring may be due to a number of causes, some of which require short-term fixes and others require long-term lifestyle changes.
Snoring can be understood by learning about some basic physics that we all encounter in our daily lives.
The challenge is to determine whether the spouse is merely making noise, or if there is a more significant health problem that needs to be addressed.
What is snoring?
Everyone snores at certain times in their life. Sleep can be disrupted, but not always. Snoring can occur because of several factors:
- Partial obstruction of nasal or oral airways
- Alcohol consumption
- Sedative medication
- Being overweight
Technically, snoring is the harsh noise that is caused by the vibration of tissues in the back of our throats. It manifests because of a combination of airway obstruction due to infections or allergies, excess floppy tissues, and muscle relaxation.
Snoring occurs more in men than women, and in about 25% of children. Snoring by itself is just noise, but it is almost always because of some underlying cause. The key issue is to diagnose and fix that underlying cause and the snoring will typically go away along with it.
Obstructive sleep apnea: most common cause of snoring
The most significant cause of snoring overlaps with its signs and symptoms, and that is obstructive sleep apnea. If your spouse is snoring, one of the vital determinations that your healthcare provider will need to make is whether they are also stopping breathing.
As with the diagnosis, snoring and sleep apnea have overlapping treatments. Some of these are conservative such as diet and exercise, others involve machines such as a CPAP or changes in sleeping positions.
Different types of snoring
Age and sound of snoring can play a major role in diagnosing the cause and subsequent treatment.
- In children. Snoring is so specific and informative that it provides pediatricians and other healthcare providers clues as to the child’s level of obstruction. Noisy breathing can indicate mild or severe problems that necessitate urgent care. In adults.
- In adults. Snoring encompasses a wide variety of airway disruptions. Primary snoring is common, but again it often is a result of either a temporary cause such as a stuffy nose from a cold, or a long-standing one such as obstructive sleep apnea.
The removal of benign stimuli such as nasal congestion, excess fatigue, or taking central nervous system depressants like antihistamines may represent an easy solution. Another popular solution is to try to get the bed partner to sleep on their side. Years ago, frustrated spouses sewed tennis balls into the backs of the spouse’s pajamas or nightshirts to prevent them from sleeping flat on their backs.
Risk factors for sleep apnea
Along with snoring, obstructive sleep apnea can be ubiquitous. Many people complain that they don’t know that they snore because, of course, they are asleep. But many also complain of daytime somnolence or tiredness, loss of motivation, and cognitive decline because they are not getting a proper night’s sleep.
The risk factors for sleep apnea associated with primary snoring include:
- Obesity. Body Mass Index of 30 kg/m2.
- Sex. 4% of men and 2% of women are affected.
- Obstruction. Physicians will assess the degree of upper airway obstruction and its cause.
- Neck size. Associated anthropomorphic measures, especially neck circumference. A neck circumference of more than 43 cm or 17 inches is a high predictor of obstructive sleep apnea.
- Disease. Pulmonary diseases such as COPD, restrictive, or neurologic diseases of the lungs.
- Depressants. Central nervous system depressants including alcohol, sleeping pills, and other medications.
- Smoking. Tobacco use and smoking are risk factors.
- Hypothyroidism (low thyroid). Thyroid function is implicated in sleep apnea.
- Sleeping position. Sleeping supine or on your back.
- Facial shape. Craniofacial abnormalities and prior trauma or surgery affecting the upper airway, especially the palate, pharynx, nose, and nasal cavity.
Airflow from the upper airway may be affected by:
- Small airway size
- Upper airway resistance
- Negative inspiratory pressure
- Extraluminal pressure
- Small mandible or jaw
- Upper airway inflammation
Bernoulli principle and Venturi Effect
In obese people, even though there may be a large airway due to physical and special relationships, the excess adipose tissue can cause airway collapse. The impeded flow of air is what results in the noise of snoring, or in many cases, obstructive sleep apnea as well.
- The Bernoulli principle. Describes the fluid flow in a column. A partial vacuum exists at the outer edges of the column. As airflow increases, the vacuum pressure increases, and vice versa. It is the same principle as drinking through a straw. If too much negative pressure is generated in the straw, the straw collapses. The same thing happens in your airway to cause primary snoring or obstructive sleep apnea. It also allows airplanes to lift off.
- The Venturi effect. It describes the acceleration of airflow as we breathe in, and our airway is narrowed. The effect is like when water sprays out of a hose that we occlude with our thumb. The water sprays faster. In the case of a narrowed throat, the mobility of the tissues determines the width. Inhaled air accelerates through the throat, causing snoring or rattling of the tissues.
If your spouse is snoring, it may be due to a multitude of reasons. It is important to undergo a medical evaluation, preferably with an ENT doctor, to determine the degree of upper airway obstruction, if any. It is also important to decide whether obstructive sleep apnea also accompanies primary snoring.
Getting your spouse evaluated is the first step in preventing a “sleep divorce”. Next, try changing the bed partner’s sleep position, eliminate smoking and tobacco smoking, and concentrate on a healthy diet and exercise.
- Cleveland Clinic. Snoring.
- Skybrary. Bernoulli's principle.
- Comsol. Exploring the Venturi effect.
- Sleep. Snoring. A source of noise pollution and sleep apnea predictor.
- Nationwide Children's. Noisy breathing.