The Serious Side of Snoring

How to tell if your snoring is just plain old annoying or if you should probably see a doctor

Man snoring in bed

Snoring can come from all shapes and sizes. For instance, have you ever seen Jurassic Park?

There’s a famous scene where the Tyrannosaurus Rex, a towering prehistoric leviathan, unwittingly gives away its presence to the main characters when its lumbering footsteps send small shock waves through a glass of water in their vehicle. It’s an incredible piece of cinematography, conveying the monolithic scale of the monster by insinuation as opposed to just showing the scaly-skinned pursuer.

Now let’s take my sleeping mother, put that same glass a hundred yards away, and watch as her snores not only vibrate the water but shatter the glass. Her snores are something of a legend.

I come from a family of earth-shaking snorers, so snore-centric sleep health is near and dear to me. I think it’s important we take a thorough look at what snoring is, and why it might be a sign of certain body systems going off the rails.

Do we take snoring seriously enough?

Snoring is funny. I think it’s funny. Well, I used to.

We’ve been conditioned to think in such a way. Between cartoons, film, and comic strips, we find a loud and exaggerated snore comedic. However, off of the screen (or page), snoring can be an indicator of damaging lifestyle factors or life-threatening health problems like sleep apnea.

With 40% of men and 24% women snoring habitually, this is a widespread issue not to be taken lightly. Many who snore fail to realize these sounds can be a signal from the body screaming that something is wrong, or worse – a symptom of several potentially life-threatening disorders.

Snoring can be an indicator of damaging lifestyle factors or life-threatening health problems like sleep apnea.

What is snoring? 

Simply put, snoring is when you try to squeeze air through the narrow and/or flabby parts of your airways while you’re sleeping. The tissues flap and vibrate – producing the staccato rasps we know as a snore.

Your soft palate (fleshy tissue making up the rear roof of the mouth extending towards the throat), the base of the tongue, and windpipe (or airway) are the three heads of Cerberus guarding the entrance to your lungs, and the majority of snoring issues arise from one of, or some interplay between, the trio.

Diagram of snoring provided by the Mayo Clinic
Diagram of snoring provided by the Mayo Clinic

What causes snoring? 

There are many risk factors that increase the probability and severity of snoring. They most often are:

Obesity

Fat deposits on the neck, chin, and chest can all help close off the airway and put pressure on the base of the tongue, making the passageway to your lungs that more much constricted.

Alcohol Consumption

Alcohol is a central nervous system depressant, which means it relaxes the muscles in your body – tongue and throat included. When throat and tongue muscles around the airway are relaxed, the tissues have less structure and support and so restrict the flow of air.

Medications

Similar to alcohol, many common medications cause CNS depression and relaxation of the muscles. Benzodiazepines, painkillers, and muscle relaxants all leave important muscular structures loosened while allergy medications that tend to dry mucosal membranes in our breathing passages have been shown to increase the prevalence of snoring as well.

Sex

We’re not talking about post-coital snoozing here. Men, statistically, are more prone than women to snoring. Unlike the above risk factors, this one is a smidge more difficult to remedy.

Men, statistically, are more prone than women to snoring.

Smoking

Cigarettes are known to cause inflammation of the airways, restricting breathing. The science on linking cannabis and e-cig use to snoring is murkier, but at least in the case of marijuana use research has suggested it can act in a way similar to muscle relaxants.

Nasal Blockages

Things like congestion, growths in the nose, misaligned bones after a break, and deviated septums can all contribute to impeded or altered air flow through upper airways.

Morphology

Some people just have bad luck. You could have a naturally thinner trachea or a longer and more hindering soft palate. Might just be a case of the cards you were dealt.

Should I be concerned if I snore?

Maybe.

I don’t want to go the WebMD route and convince you it means you’ll die of incurable brain cancer in a few weeks, but snoring can be a sign of some serious sleep disorders – namely sleep apnea.

At its most mild and intermittent, snoring may cause some fragmented sleep and irritation of the soft tissues along your airway. Not great, not terrible. Many people that snore suffer no devastating adverse effects and have no underlying disease or disorder, just possessing one or more of the risk factors above. Quitting smoking and losing weight might do it for them.

There are, however, a portion of serial snorers out there for whom the nightly roars serve as a sign of something much more serious than the fact that you might have a chubby neck.

Snoring can be a sign of some serious sleep disorders – namely sleep apnea.

Sleep Apnea

Sleep apnea is a disorder characterized by momentary lapses in breathing occurring during sleep. Individuals with the disorder often find themselves waking up struggling for air after an episode of hypoxia, the body reacting violently to being starved of oxygen.

These respiratory pauses can either be mechanical (physical blockage of the airway due to extraordinary muscle relaxation or swelling) or chemical (a lack of signals from the brain telling the body to breathe) and occur anywhere between five to 100 times an hour.

The two are referred to as Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA) respectively, with the former the most common manifestation of the disorder. The combination of the two is known as Complex Sleep Apnea Syndrome or Treatment-Emergent Central Sleep Apnea.

The disorder is disconcertingly common. 3-7% of adult men and 2-5% of adult women have OSA severe enough to bring about daytime sleepiness. The true prevalence is like much higher, with the medical community believing sleep apnea is heavily under-reported.

3-7% of adult men and 2-5% of adult women have OSA severe enough to bring about daytime sleepiness.

Symptoms of Sleep Apnea 

Whether it’s a buildup of fluid in the neck or a genetic disorder like Polycystic Ovarian Syndrome, sleep apnea poses grave health risks to afflicted individuals – even though the symptoms don’t always seem obvious.

Loud and frequent snoring is the most common symptom in sleep apnea cases, but it’s not necessarily there 100% of the time. Nearly all sleep apnea patients snore, but few who snore have sleep apnea. Snoring without being affected by the disorder is known as “primary snoring.”

The second most visible symptom in cases of sleep apnea is waking during the night out of breath or gasping. This should be a pretty strong signal you need to speak with your doctor.

Other symptoms include fatigue and sleepiness, dry mouth upon waking, brain fog, sexual dysfunction, and poor sleep quality.

Not sure if you’re at risk for sleep apnea? You can start by taking this 1-2 minute sleep apnea questionnaire. Note: this is purely for informational purposes. Only a licensed doctor can provide a true medical diagnosis, but this can help you understand if you display some of the symptoms of sleep apnea.

Complications of Sleep Apnea

But wait, it gets worse.

Undiagnosed or untreated sleep apnea can result in a laundry list of potentially life-threatening conditions including but not limited to:

  • Cardiovascular disease
  • Cancer
  • Asthma
  • Liver problems
  • Metabolic disorders
  • Kidney disease
  • Behavioral disorders
  • Disorders of the eye
  • Complications during pregnancy
  • Dangerous interactions with sedatives and painkillers

The mechanisms that connect sleep apnea with the above disorders are many and complex, and should be spoken with a trained medical professional. 

Undiagnosed or untreated sleep apnea can result in a laundry list of potentially life-threatening conditions.

So if I snore and don’t have sleep apnea, I’m good? 

Well, maybe not. Emergent research has suggested a relationship between the so-called “primary snoring” discussed previously and a thickening of the arterial walls in the carotid arteries.

These two arteries fork from the aorta and are responsible for delivering blood to the head and brain. Obviously, the restriction of blood to the brain is a very serious issue, and this sort of impediment in delivering oxygen to the brain has a strong relationship with increased risk of a stroke.

It’s important to note that in this study, subjects were chosen specifically that snored habitually but did not have sleep apnea. Despite being just primary snorers, these individuals showed much higher rates of carotid thickening than did non-snorers. Additionally, this type of carotid thickening was not present in others at risk for cardiovascular disease like smokers or those with high cholesterol.

While the link here might seem equal parts convincing and terrifying, the research has been met with conflicting studies that show no evidence of carotid dysfunction amongst primary snorers. The suggestion, perhaps, is that snoring is a symptom of other dysfunctions or detrimental lifestyle factors that would also contribute to cardiovascular disease  – as opposed to the root cause.

Treatment options

It gets complicated here. Sleep apnea is more an umbrella term for disorders that cause repeated and complete obstruction of airways during sleep than a specific disorder with one single cause. Tonsils, tongues, and tracheal issues (among many others) could all be the culprit of your breathing obstruction.

Continuous Positive Airway Pressure (CPAP) machines are the most oft-prescribed solution for sufferers of sleep apnea. The machine pumps a pressurized stream of air into a mask secured onto sleeping users, forcing their airways to stay open during the night.

While there are other treatments available, some for the symptoms and some to fix the underlying disorder responsible for your sleep apnea, we’ll leave that to the doctors to discuss.

Try not to lose sleep over it

It’s important to remember that most snoring is probably fairly inconsequential. Even if you’re a loud snorer, the chances of having a stroke or going into cardiac arrest during your sleep are minimal.

However, habitual snorers should probably see their primary care doctor if for no other reason than to give them peace of mind. As always, sleep disorders are never improved by stress and sleep loss, so it’s important to get to the root of the issue as opposed to letting it stew.

For more on earth-shattering snores the dangers of having a double chin, stay tuned on Mattress Advisor.