Prosper Ikiriko

TABLE OF CONTENT

Chapter One…What is SnoringChapter Two…When Snoring Occurs Chapter Three…. What Causes Snoring Chapter Four……Other Causes of Snoring Chapter Five…How to Treat SnoringChapter Six… Nonsurgical Treatment of SnoringChapter Seven…Surgical Treatment of Snoring

Conclusion

References

SNORING IS IT HEALTHY?

WHAT IS SNORING

Snoring is the hoarse or harsh sound that occurs when air flows past relaxed tissues in your throat, causing the tissues to vibrate as you breathe. Snoring occurs when something restricts your airflow during sleep. Loud or long-term snoring increases the risk of heart attack, stroke and other health problems. Snoring can make for a bad nights sleep, for you and your bed mate. But if it happens because you have obstructive sleep apnea (OS ), its a sign of a bigger problem it occurs in roughly 57% of adult men and 40% of women. Of these, one quarter are considered habitual snorers. About 10-12% of children also snore. Snoring on its own is usually considered aharmless – albeit highly disruptive -phenomenon, but for some people it indicates a more serious underlying medical condition or sleep disorder.

WHEN SNORING OCCURS

Snoring occurs when airflow is blocked or restricted in the nasopharynx4, an area of the upper airway located behind your nose. Tissues in the airway flutter and strike each other to produce the telltale snoring sound, which can range from light and barely audible to heavy and disruptive.For some people, heavy snoring indicates the presence of sleep apnea, a sleep-related breathing disorder that causes people to choke or gasp for air in their sleep. Snoring is considered the chief symptom of obstructive sleep apnea (OSA), a condition attributed to a physical blockage that restricts respiratory activity in the upper airway.Roughly 2-9% of adults live with OSA. Episodes involving a complete loss of airflow are called apneas, and episodes with reduced airflow are known as hypopneas. Apneas and hypopneas occur five to 15 times per hour in people with mild OSA, 16 to 30 times per hour in those with moderateOSA, and more than 30 times per hour in those with severe OSA.Considering each apnea normally lasts at least 30 seconds, even mild OSA can be disruptive to the sleeper and anyone who shares their bed. Snoring may accompany apnea-hypopnea episodes or occur independently during the night. Excessive daytime sleepiness from not getting enough rest is another common symptom of OSA.Risk factors for OSA include:• Obesity: Obese people may be susceptible to OSA if they have fat deposits around the neck that restrict the upper airway.• Enlarged tonsils or adenoids: Due to their placement around the upper airway, tonsils and adenoids can both block the upper airway if they are large enough. For many children with OSA, removing the tonsils and/or adenoids will help alleviate their symptoms.• Endocrinedisorders:Theendocrine system releases hormones that can interfere withbreathing during sleep.Hypothyroidism, a condition characterized by low levels ofthyroid hormone, andacromegaly, which causes high growth hormone levels, are both associated with sleep apnea. Hypogonadism, a condition withdecreased testosteroneproduction, when treated withtestosterone replacementtreatment, can worsen sleep apnea in men.• Genetic syndromes: Somegenetic syndromes affect how the face and jaw are structured, leading to airway restriction. Some examples include cleft lip and cleft palate, Down syndrome, and congenitalcentral hypoventilation syndrome. Based on testing for at least five apnea-hypopnea episodes per hour, roughly 24% of men and 7% of women live with sleep apnea. Obese people and the elderly are considered at higher risk for OS . Its also believed that consuming alcohol or sedating medications before bed can exacerbate OSA symptoms.Central sleep apnea, which occurs when the brain cannot properly signal the muscles that control breathing, may also produce snoring, but this is less common. Another sleep disorder, upper airway resistance syndrome, can cause snoring due to airway restriction but does not include apnea or hypopnea episodes. Additionally, sleep-related bruxism – also known as nocturnal teeth-grinding – is associated with snoring, particularly in children.Any sleep disorder should be taken seriously. If you or your partner are concerned about heavy snoring, you should schedule a visitwith your doctor to discuss the situation.People with OSA often benefitfrom continuous positive air pressure(CPAP) therapy, which administers air that is pressurized at a prescribed rate to ease breathing during the night.

WHAT CAUSES SNORING

When you breathe, you push air through your nose, mouth and throat. If the airway is restricted, tissues — including the soft palate (the back of the roof of the mouth), tonsils, adenoids and tongue — vibrate against each other as you force air through. The vibrations make a rumbling, rattling noise. Several conditions and factors can block airflow. These include:• Alcohol and other sedatives that relax muscles, restricting airflow.••••••Bulky soft tissue, including enlarged adenoids, tonsils or tongue.Excess body fat, which puts pressure on the soft tissues and compresses the airway.Pregnancy hormones that cause inflammation in the nose.Low muscle tone and muscle weakness in the mouth, nose or throat.Nasal congestion and inflammation due to a cold, flu, allergies or irritants in the air.Structural differences in the mouth, nose or throat that decrease the size of the airway.

OTHER CAUSES OF SNORING

While snoring does not necessarily indicate the presence of a sleep disorder, it can disrupt sleep for you and your partner. Snoring is associated with obesity and old age even for those who do not have sleep apnea symptoms. Other risk factors for snoring include:• Consumption of sedatives like alcohol and sleep-inducing medications• Chronic nasal congestion or blockage• A relatively small or displaced jaw• Pregnancy• Postmenopausal statusAnother common cause of snoring is back sleeping, which can affect breathing by restricting the airway. People who snore areoften encouraged to sleep on their sides instead.

HOW TO TREAT SNORING

Your provider will ask you (and perhaps your partner) several questions, including how often you snore, what it sounds like and how your diet and lifestyle affect your sleep. During an exam, your provider will check your blood pressure, listen to your heart and look in your mouth, nose and throat.To evaluate your sleep patterns, yourprovider may order a sleepstudy (polysomnogram). You might be able to do a sleep study at home, or you may need to spend the night in a sleep center. A sleep study evaluates:• Brain wave activity.• Breathing patterns, including any periods when you stop breathing or gasp for air.• Heart rate and oxygen levels.• Movements during sleep, such as arm or leg movements or tossing and turning.• Sleep cycles and snoring.

WHAT ARE THE NONSURGICAL TREATMENT FOR SNORING

Your provider may recommend treatments to improve your posture or open your airways when you sleep. Remedies for snoring include:•Lifestyle changes: Avoiding alcohol before bed, changing your sleep position and maintaining a healthy weight can reduce snoring.•••Medications: Cold and allergy medications relieve nasal congestion and help you breathe freely.Nasal strips: Flexible bands stick to the outside of your nose and keep nasal passages open.Oral appliances: Wearing an oral appliance when you sleep keeps your jaw in the proper position so air can flow. Your healthcare provider might call it a mouth device or mouthguard. A mouth guard used for other purposes, like sports, won resolve snoring. People who see their doctor about snoring may be evaluated for sleep apnea. The examination may include an examination of the nose and mouth to check for a physical obstruction, as well as other warning signs such as nasal polyps, a high or narrow arched palate, a displaced jaw, or enlarged tonsils or adenoids. Anti-snoring mouthguards have proven effective for some people. Tongue-retaining devices (TRDs) form a seal around the tongue and hold it in place. These appliances can alleviate snoring for people whose tongues tend to fall in the back of their throat when they sleep. Mandibular advancement devices (MADs) physically move the tongue and jaw forward, allowing for maximum airflow. In certain cases, surgery may be advised. During a uvulopalatopharyngoplasty procedure, the patients uvula, palate, and pharyngeal walls are removed to create more space for the upper airway. However, this is a procedure that requires general anesthesia and may not be the most practical – or cost-effective – way to correct snoring.

WHAT ARE THE SURGICAL TREATMENTS FOR SNORING?

In some cases, snoring and sleep disordered breathing are treated with surgery to shrink or remove excess tissue or correct a structural problem. Many of these procedures are minimally invasive. Your provider uses small incisions, and you may be able to go home the same day. Surgery for snoring includes:• Laser-assisted uvulapalatoplasty (LAUP): LAUP reduces tissue in the soft palate and improves airflow.• Radio frequency-ablation: Also called Somnoplasty, this technique uses radio frequency energy to shrink excess tissue in the soft palate and tongue.• Septoplasty: This procedure straightens a deviated septum inthe nose.A septoplasty improves airflow through the nose by reshaping the cartilage and bone.• Tonsillectomy and adenoidectomy: The surgeon remove excess tissue from theback of the throat(tonsillectomy) or the back of the nose (adenoidectomy).

CONCLUSION

Habitual snoring may be more than just a nuisance. Aside from disrupting a bed partners sleep, if snoring is associated with OSA, you may be at risk for other complications, including:• Daytime sleepiness• Frequent frustration or anger• Difficulty concentrating• A greater risk of high blood pressure, heart conditions and stroke• An increased risk of behavior problems, such as aggression or learning problems, in children with OSA• An increased risk of motor vehicle accidents due to lack of sleep.

REFERENCES

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https://www.enthealth.org/conditio ns/snoring-sleeping-disorders-and-sleep-apneaAmerican Academy of Sleep Medicine. (2014). The InternationalClassification of Sleep Disorders -Third Edition (ICSD-3). Darien,IL.https://aasm.org/Schwab, R. (2020, June). Snoring. Merck Manual Consumer Version. Retrieved October 30, 2020, from

https://www.merckmanuals.com/pr ofessional/neurologic-disorders/sleep-and-wakefulness-disorders/snoringNational Cancer Institute. (n.d.). Nasopharynx. Retrieved October 30,2020, fromhttps://www.cancer.gov/publication s/dictionaries/cancer-terms/def/nasopharynxSchwab, R. (2020, September). Obstructive Sleep Apnea. Merck Manual Consumer Version. RetrievedOctober 30, 2020, from

https://www.merckmanuals.com/pr ofessional/pulmonary-disorders/sleep-apnea/obstructive-sleep-apneaNational Heart, Blood, and LungInstitute. (n.d.). Sleep Apnea.Retrieved October 30, 2020, fromNIH Office of Communications and Public Liaison. (2017, July). Struggling to Sleep? Don Let pnea Steal Your Sweet Dreams. NIH News in Health. Retrieved October 30, 2020, from U.S. National Library of Medicine.(2016, August 4). Snoring.MedlinePlus. Retrieved October 30, 2020,